Thromboembolic Complications in Patients Undergoing In Vitro
Fertilization: Retrospective Clinical Study
Mára M., Koryntová D., Řežábek K., Kaprál A., Drbohlav P., Jirsová S., Živný J.
Gynekologicko-porodnická klinika 1. LF UK a VFN, Praha, přednosta prof. MUDr. J. Živný, DrSc. |
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Summary:
Objective: To determine the incidence and the type thromboembolic complications in patients
undergoing in vitro fertilization (IVF). To evaluate their clinical course, the infl uence on reproductive
outcomes, and the prevalence of thrombophilia in these women.
Design: Retrospective clinical study.
Setting: Assisted Reproduction Center, Department of Obstetrics and Gynecology, 1st Faculty of
Medicine and General Faculty Hospital, Charles University, Prague.
Methods: The data, refl ecting the diagnosis of thromboembolism (TE), were collected from all
patients, who have undergone the IVF cycle in our clinic for the last 7 years. The following data
were analyzed in these patients: medical history, type and course of TE, type and effect of ovarian
stimulation, clinical pregnancy achievement, occurrence of ovarian hyperstimulation syndrome
(OHSS), results of testing for thrombophilia, pregnancy course and outcome.
Results: From 2748 IVF cycles 3 cases of TE were found (0.11%). In all cases the unilateral thrombosis
of internal jugular vein associated with OHSS, manifesting in 1st trimester of pregnancy
and not complicated with pulmonary embolism occurred. At least two thrombophilic markers
have been detected in all these women. The clinical course of TE, as well as of the whole gestation
was favorable. Prevalence of TE in patients with severe OHSS was 4.1% (2 women from 49).
Conclusion: The incidence of thromboembolism in women undergoing IVF is low. It appears almost
exclusively in association with OHSS and the typical fi nding is deep venous thrombosis in
the neck area. In our opinion, while screening of thrombophilia in all patients from IVF program
is not indicated, the routine testing of most common thrombophilic markers in pregnant women
with OHSS could decrease the risk of these serious complications.
Key words:
IVF, OHSS, thromboembolism, thrombophilia
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