Clinical utility of antithrombotic prophylaxis in ART procedures: an Italian experience

PLoS One. 2014 May 28;9(5):e97604. doi: 10.1371/journal.pone.0097604. eCollection 2014.

Abstract

Background: The usefulness of antithrombotic prophylaxis in management of Assisted Reproductive Technologies (ART) is questionable.

Objectives: We prospectively examined the contribution of an antithrombotic prophylaxis in influencing clinical pregnancy and live-birth in an unselected cohort of women approaching ART.

Patients/methods: 1107 women with fertility problems and a valid indication for ART were recruited. Baseline and follow-up information of obstetric outcomes and antithrombotic treatment were collected.

Results and conclusions: Median follow-up time was 34.5 months (range: 2-143). During the follow-up period, 595 (53.8%) women underwent ART (total 1234 cycles); 202 (33.9%) women achieved a pregnancy for a total of 255 clinical pregnancies. The concomitant use of LMWH and aspirin was significantly associated with a higher rate of clinical pregnancies (p: 0.003, OR: 4.9, 95% CI: 1.7-14.2). The pregnancy rate was also significantly increased by the use of LMWH alone (p: 0.005, OR: 2.6, 95% CI: 1.3-5.0). Carriership of inherited or acquired thrombophilia did not affect clinical outcomes of the ART. The efficacy of antithrombotic treatment was confirmed when the outcome " live-birth" was considered. Present data suggest a potential benefit of antithrombotic prophylaxis during ART in improving the number of live-births.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cohort Studies
  • Female
  • Fibrinolytic Agents / pharmacology*
  • Humans
  • Italy / epidemiology
  • Live Birth / epidemiology*
  • Logistic Models
  • Odds Ratio
  • Pre-Exposure Prophylaxis / methods*
  • Pregnancy
  • Prospective Studies
  • Reproductive Techniques, Assisted*

Substances

  • Fibrinolytic Agents

Grants and funding

The study was supported by grants from Italian Ministry of Health (Ricerca Corrente 2012). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.