Thrombophilia has been associated with pregnancy complications and recurrentmiscarriage. The aim of this systematic review was to evaluate the controversial association between thrombophilia and failures of assisted reproductiontechnology (ART). A systematic search of the literature for studies reporting on thrombophilia in women undergoing ART up to April 2011 yielded 33 studies (23evaluating anti-phospholipid antibodies, 5 inherited thrombophilia, and 5 both)involving 6092 patients. Overall, methodologic quality of the studies was poor.Combined results from case-control studies showed that factor V Leiden wassignificantly more prevalent among women with ART failure compared with fertileparous women or those achieving pregnancy after ART (odds ratio = 3.08; 95%confidence interval, 1.77-5.36). The prothrombin mutation,methylenetetrahydrofolate reductase mutation, deficiency of protein S, protein C,or anti-thrombin were all not associated with ART failure. Women with ART failuretested more frequently positive for anti-phospholipids antibodies (odds ratio =3.33; 95% confidence interval, 1.77-6.26) with evidence of high degree ofbetween-study heterogeneity (I(2) = 75%; P < .00001). Prospective cohort studies did not show significant associations between thrombophilia and ART outcomes.Although case-control studies suggest that women experiencing ART failures aremore frequently positive for factor V Leiden and anti-phospholipid antibodies,the evidence is inconclusive and not supported by cohort studies.
Thrombophilia and outcomes of assisted reproduction technologies: a systematic review and meta-analysis
Rutjes A;
2011-01-01
Abstract
Thrombophilia has been associated with pregnancy complications and recurrentmiscarriage. The aim of this systematic review was to evaluate the controversial association between thrombophilia and failures of assisted reproductiontechnology (ART). A systematic search of the literature for studies reporting on thrombophilia in women undergoing ART up to April 2011 yielded 33 studies (23evaluating anti-phospholipid antibodies, 5 inherited thrombophilia, and 5 both)involving 6092 patients. Overall, methodologic quality of the studies was poor.Combined results from case-control studies showed that factor V Leiden wassignificantly more prevalent among women with ART failure compared with fertileparous women or those achieving pregnancy after ART (odds ratio = 3.08; 95%confidence interval, 1.77-5.36). The prothrombin mutation,methylenetetrahydrofolate reductase mutation, deficiency of protein S, protein C,or anti-thrombin were all not associated with ART failure. Women with ART failuretested more frequently positive for anti-phospholipids antibodies (odds ratio =3.33; 95% confidence interval, 1.77-6.26) with evidence of high degree ofbetween-study heterogeneity (I(2) = 75%; P < .00001). Prospective cohort studies did not show significant associations between thrombophilia and ART outcomes.Although case-control studies suggest that women experiencing ART failures aremore frequently positive for factor V Leiden and anti-phospholipid antibodies,the evidence is inconclusive and not supported by cohort studies.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
