ARCHIVEOBSTETRICS AND GYNECOLOGY
International Medical Journal, Vol. 22., Iss. 2, 2016, P. 35−38.
PATHOGENETIC RISK FACTORS OF UNSUCCESSFUL IN VITRO FERTILIZATION IN WOMEN WITH THROMBOPHILIA
Kharkiv National Medical University, Ukraine
Identification of the pathophysiological mechanisms of infertility and unsuccessful attempts of in vitro fertilization is an important issue of modern reproductology. The aim of this study was to determine the risk factors of thrombosis formation in patients with thrombophilia, leading to unsuccessful attempts at IVF. All patients were examined for the presence of antiphospholipid syndrome and hereditary gene polymorphism predisposition to thrombophilia. The study revealed that the presence of genetic thrombophilia, especially their combination with antiphospholipid syndrome (APLS), may be the cause of clinically diagnosed early pre−embryonic losses. It revealed a significantly higher incidence of various structural forms of thrombophilia in patients with failed IVF. Etiopatogenetic risk factors for failed attempts of IVF in women with thrombophilia are the presence of APLS and the genetic thrombophilia (FV Leiden mutation, prothrombin G20210A mutation, MTHFRS677T polymorphism gene PAI−1 or other thrombogenic defects in fibrinolysis, and platelets count), the combination of which greatly increases the risk of thrombotic complications and leads to a lack of embryo implantation into the uterine cavity; the prevalence in the structure of multigenic thrombophilia, gene polymorphism, and endogenous hypofibrinolysis of synchronization processes of fibrinolysis and fibrin, as well as a high concentration of circulating APL antibodies in conjunction with hyperhomocysteinemia cofactors and antibodies to APL antibodies.
Key words: risk factors, unsuccessful IVF attempts, thrombophilia.