Low-molecular-weight heparin in women with repeated implantation failure

Corrado Lodigiani, Pierpaolo Di Micco, Paola Ferrazzi, Luca Librè, Veronica Arfuso, Franco Polatti, Benigna Michela, Roberta Rossini, Emanuela Morenghi, Lidia Rota, Benjamin Brenner, Emanuele Levi Setti Paolo

Research output: Contribution to journalArticle

Abstract

Implantation failure is common in assisted reproduction techniques (ART). The role of low-molecular-weight heparin (LMWH) is a matter of debate as a potential factor to improve implantation. Aim: To evaluate the pregnancy rate in patients with or without heparin administration. Materials & methods: We performed a retrospective observational analysis of patients with at least two IVF/intracytoplasmic sperm injection cycles with implantation failure, screened for inherited thrombophilia and submitted to further ART cycles with or without administration of LMWH. A total of 265 patients fulfilled the enrollment criteria. Of these 149 (56%) were primary infertile and 116 (44%) were secondary infertile. Their mean age was 36.3 ± 3.6 years. We analyzed basal FSH, smoking habit, gene variants for inherited thrombophilia (i.e., MTHFR C677T, prothrombin G202A10G and Factor V Leiden). The patients underwent 569 new ART cycles: 512 (90%) without and 57 (10%) with LMWH. Results: In total 105 clinical pregnancies were observed in 569 cycles (18.8%). The pregnancy rate was 17.19% (88/512) in patients not treated with LMWH and 29.52% (17/57) in the LMWH-treated group (p = 0.006). In women over 36 years of age the pregnancy rate was 15.53% (50/322) in nontreated versus 35.71% (10/28) in treated cycles (p = 0.007), while no difference was found in younger women. No statistical difference was found between the presence of inherited thrombophilia and pregnancy rate in treated and untreated cycles. Discussion: significantly higher pregnancy rate in patients with previous ART implantation failures was observed with LMWH. Our results confirm no relation among inherited thrombophilia and pregnancy rate in patients with previous IVF implantation failures. These findings should be confirmed by randomized controlled trials before use of LMWH for ART cycles is recommended.

Original languageEnglish
Pages (from-to)425-431
Number of pages7
JournalWomen's Health
Volume7
Issue number4
DOIs
Publication statusPublished - Jul 2011

Fingerprint

Low Molecular Weight Heparin
Reproductive Techniques
Pregnancy Rate
Thrombophilia
Intracytoplasmic Sperm Injections
Prothrombin
Habits
Heparin
Randomized Controlled Trials
Smoking
Pregnancy
Genes

Keywords

  • assisted reproduction techniques
  • Factor V Leiden
  • female infertility
  • low-molecular-weight heparin
  • MTHFR C677T
  • prothrombin A20210G
  • repeated implantation failure
  • thrombophilia

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Low-molecular-weight heparin in women with repeated implantation failure. / Lodigiani, Corrado; Di Micco, Pierpaolo; Ferrazzi, Paola; Librè, Luca; Arfuso, Veronica; Polatti, Franco; Michela, Benigna; Rossini, Roberta; Morenghi, Emanuela; Rota, Lidia; Brenner, Benjamin; Paolo, Emanuele Levi Setti.

In: Women's Health, Vol. 7, No. 4, 07.2011, p. 425-431.

Research output: Contribution to journalArticle

Lodigiani, C, Di Micco, P, Ferrazzi, P, Librè, L, Arfuso, V, Polatti, F, Michela, B, Rossini, R, Morenghi, E, Rota, L, Brenner, B & Paolo, ELS 2011, 'Low-molecular-weight heparin in women with repeated implantation failure', Women's Health, vol. 7, no. 4, pp. 425-431. https://doi.org/10.2217/whe.11.38
Lodigiani, Corrado ; Di Micco, Pierpaolo ; Ferrazzi, Paola ; Librè, Luca ; Arfuso, Veronica ; Polatti, Franco ; Michela, Benigna ; Rossini, Roberta ; Morenghi, Emanuela ; Rota, Lidia ; Brenner, Benjamin ; Paolo, Emanuele Levi Setti. / Low-molecular-weight heparin in women with repeated implantation failure. In: Women's Health. 2011 ; Vol. 7, No. 4. pp. 425-431.
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abstract = "Implantation failure is common in assisted reproduction techniques (ART). The role of low-molecular-weight heparin (LMWH) is a matter of debate as a potential factor to improve implantation. Aim: To evaluate the pregnancy rate in patients with or without heparin administration. Materials & methods: We performed a retrospective observational analysis of patients with at least two IVF/intracytoplasmic sperm injection cycles with implantation failure, screened for inherited thrombophilia and submitted to further ART cycles with or without administration of LMWH. A total of 265 patients fulfilled the enrollment criteria. Of these 149 (56{\%}) were primary infertile and 116 (44{\%}) were secondary infertile. Their mean age was 36.3 ± 3.6 years. We analyzed basal FSH, smoking habit, gene variants for inherited thrombophilia (i.e., MTHFR C677T, prothrombin G202A10G and Factor V Leiden). The patients underwent 569 new ART cycles: 512 (90{\%}) without and 57 (10{\%}) with LMWH. Results: In total 105 clinical pregnancies were observed in 569 cycles (18.8{\%}). The pregnancy rate was 17.19{\%} (88/512) in patients not treated with LMWH and 29.52{\%} (17/57) in the LMWH-treated group (p = 0.006). In women over 36 years of age the pregnancy rate was 15.53{\%} (50/322) in nontreated versus 35.71{\%} (10/28) in treated cycles (p = 0.007), while no difference was found in younger women. No statistical difference was found between the presence of inherited thrombophilia and pregnancy rate in treated and untreated cycles. Discussion: significantly higher pregnancy rate in patients with previous ART implantation failures was observed with LMWH. Our results confirm no relation among inherited thrombophilia and pregnancy rate in patients with previous IVF implantation failures. These findings should be confirmed by randomized controlled trials before use of LMWH for ART cycles is recommended.",
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AU - Arfuso, Veronica

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AU - Michela, Benigna

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AB - Implantation failure is common in assisted reproduction techniques (ART). The role of low-molecular-weight heparin (LMWH) is a matter of debate as a potential factor to improve implantation. Aim: To evaluate the pregnancy rate in patients with or without heparin administration. Materials & methods: We performed a retrospective observational analysis of patients with at least two IVF/intracytoplasmic sperm injection cycles with implantation failure, screened for inherited thrombophilia and submitted to further ART cycles with or without administration of LMWH. A total of 265 patients fulfilled the enrollment criteria. Of these 149 (56%) were primary infertile and 116 (44%) were secondary infertile. Their mean age was 36.3 ± 3.6 years. We analyzed basal FSH, smoking habit, gene variants for inherited thrombophilia (i.e., MTHFR C677T, prothrombin G202A10G and Factor V Leiden). The patients underwent 569 new ART cycles: 512 (90%) without and 57 (10%) with LMWH. Results: In total 105 clinical pregnancies were observed in 569 cycles (18.8%). The pregnancy rate was 17.19% (88/512) in patients not treated with LMWH and 29.52% (17/57) in the LMWH-treated group (p = 0.006). In women over 36 years of age the pregnancy rate was 15.53% (50/322) in nontreated versus 35.71% (10/28) in treated cycles (p = 0.007), while no difference was found in younger women. No statistical difference was found between the presence of inherited thrombophilia and pregnancy rate in treated and untreated cycles. Discussion: significantly higher pregnancy rate in patients with previous ART implantation failures was observed with LMWH. Our results confirm no relation among inherited thrombophilia and pregnancy rate in patients with previous IVF implantation failures. These findings should be confirmed by randomized controlled trials before use of LMWH for ART cycles is recommended.

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