Outcomes of IVF treatments in women with antiphospholipid antibodies or antiphospholipid syndrome.

Autor: Shalamov MM; Faculty of medical and health science, Tel Aviv University, Tel Aviv, Israel., Kaufman L; Faculty of medical and health science, Tel Aviv University, Tel Aviv, Israel; Medicine B Department, Rabin Medical Center, Beilinson, Petah Tikva, Israel., Simchen MJ; Faculty of medical and health science, Tel Aviv University, Tel Aviv, Israel; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel., Agmon-Levin N; Faculty of medical and health science, Tel Aviv University, Tel Aviv, Israel; Clinical Immunology, Angioedema, and Allergy Institute, Center for autoimmune Diseases, Sheba Medical Center, Ramat-Gan, Israel., Misgav M; Blood Bank Services, Hemophilia and Thrombosis Center, Sheba Medical Center, 039439191, Israel., Orvieto R; Faculty of medical and health science, Tel Aviv University, Tel Aviv, Israel; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel., Machtinger R; Faculty of medical and health science, Tel Aviv University, Tel Aviv, Israel; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel. Electronic address: Ronit.Machtinger@sheba.health.gov.il.
Jazyk: angličtina
Zdroj: Thrombosis research [Thromb Res] 2024 Nov; Vol. 243, pp. 109144. Date of Electronic Publication: 2024 Sep 10.
DOI: 10.1016/j.thromres.2024.109144
Abstrakt: Background: Ovulation induction for in vitro fertilization (IVF) may increase intravascular thromboses among patients with antiphospholipid autoantibodies (aPLs) or antiphospholipid syndrome (APS) due to the high estrogen levels. While natural or modified natural IVF treatment cycles (MNC) are sometimes used instead of stimulated cycles with empiric anticoagulant treatment among these infertile patients, their efficacy is unclear.
Materials and Methods: A retrospective cohort study including all IVF cycles of patients diagnosed with aPLs or APS in a tertiary, university-affiliated hospital between 2012 and 2022. The outcomes of stimulated cycles with anticoagulants and MNC and natural IVF cycle attempts were compared.
Results: 121 oocyte retrievals from 38 women were analyzed: 93 stimulated and 28 MNC or natural IVF cycles. The rates of cycle cancellation (0 % vs. 17.9 %, p < 0.001) and cycles in which no oocytes were retrieved (0 % vs. 43.5 %, p < 0.001) were significantly lower following stimulated cycles vs. natural and MNC. In parallel, positive β-hCG (31.9 % vs. 10.9 %, p = 0.03), clinical pregnancy rate (23.6 % and 3.6 %, p < 0.001) and live birth rates (18.1 % vs. 3.6 %, p = 0.01) were significantly higher following stimulated cycles. No thrombotic events or bleeding occurred in any cycle.
Conclusion: Ovarian stimulation for IVF is more effective for successful pregnancy and delivery than natural cycles and MNC and can be safely undertaken in aPLs or APS women undergoing IVF. Rates of complication from hormonal treatment are not increased when treated with LMWH during ovarian stimulation.
Competing Interests: Declaration of competing interest We have confirmed that all manuscript authors contributed to the concept, design, results interpretation, and manuscript drafting. None of the authors of this study have any conflicts of interest to disclose.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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