Prophylactic low molecular weight heparin in women with thrombophilia
submitted to in vitro fertilization
Abstract
Abstract Objective: to verify if low molecular weight heparin(LMWH)
could increase pregnancy rates and/or decrease abortion rates in women
with thrombophilia undergoing assisted reproduction cycles. Design:
Retrospective study. 30 Setting: Private infertility clinic. Patients:
Patients submitted to assisted reproduction (total n=104). Women without
thrombophilia (controls, n=20), women with thrombophilia (untreated
group, n=30), and women with thrombophilia, treated with daily
enoxaparin from the day of embryo transfer until week 36 of gestation
(treated group, n=54). Interventions: Enoxaparin treatment for diagnosed
thrombophilia. All women underwent controlled ovarian hyperstimulation,
in vitro fertilization was performed by intracytoplasmic sperm
injection, embryos were transferred on day three. Pregnancy was detected
by β-hCG (biochemical) and fetal heart beat at weeks 5-6. Ongoing
pregnancy was determined by ultrasound on week 12. Main Outcome
Measures: Implantation rate, ongoing pregnancy rate, live birth rate,
early pregnancy loss rate, and abortion rate. Results and conclusion:
Patients in the Untreated Thrombophilia group presented significantly
lower ongoing pregnancy rates and live birth rates, and significantly
higher early pregnancy loss and abortion rates when compared to the
Control or the Treated Thrombophilia groups. In women with diagnosed
coagulation disorders, use of low molecular weight heparin is important
in order to avoid miscarriages.7 Keywords: female infertility;
thrombophilia; enoxaparin; abortion; in vitro fertilization