Effects of multiple inherited and acquired thrombophilia on outcomes of in-vitro fertilization

INTRODUCTION: The effects of multiple inherited and acquired thrombophilicdefects on the outcome of in-vitro fertilization (IVF) remain unexplored. The aimof this study was to evaluate the association between multiple thrombophilia and clinical outcomes in a large prospective cohort of women undergoing IVF.MATERIALS AND METHODS: Consecutive women scheduled for IVF were eligible. Theprimary study outcome was live birth. Secondary outcomes included spontaneousabortion, clinical pregnancy, and symptomatic venous thromboembolism.RESULTS: 687 women with a mean age of 34.6 (±3.2) years were included. Overall,22 women (3.2%) had two or more thrombophilic defects. The probability of livebirth was not statistically significantly different between women with ≥2thrombophilia (odds ratio [OR] 0.62; 95% confidence interval [CI], 0.18 to 2.11) or ≥1 thrombophilia (OR 0.67;95% CI, 0.41 to 1.09) and women without anythrombophilia. None of the individual inherited thrombophilia nor positivity toantiphospholipid antibodies or lupus anticoagulant were associated with livebirth. Single positivity for lupus anticoagulant carried a more than threefoldhigher risk of abortion (OR 3.74; 95% CI, 1.30 to 10.75). There were nostatistically significant associations between individual or multiplethrombophilic defects and clinical pregnancy or pregnancy test results. No woman had a history of venous thromboembolism and none developed a thrombotic eventduring the study.CONCLUSIONS: In women undergoing IVF, the presence of two or more thrombophilicdefects was rare and showed no statistically significant associations with IVFoutcomes.