2007, Number 2
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An Med Asoc Med Hosp ABC 2007; 52 (2)
Frequency of genetic markers for thrombophilia in women with failure of in vitro fertilization
Ávarez-Valero R, Aguirre-Ramos G, Méndez-González JA, Velázquez-Magaña M, González-Cofrades J, Martínez-Ruiz A, Messina VP, Navarro-Martínez C
Language: Spanish
References: 26
Page: 59-64
PDF size: 180.19 Kb.
ABSTRACT
When
in vitro fertilization (IVF) fails, etiopathologic study is delayed. Genetic mutations, which predispose to thrombophilia, must be determined as these may interrupt implantation and trophoblastic development.
Objective: To describe the incidence of genetic markers for thrombophilia in patients in whom IVF has failed.
Material and methods: Genetic markers for thrombophilia were determined in twenty women in whom IVF was unsuccessful. Numerical and categorical variables were determined and summarized as median and interquartile range, represented in frequencies and percentages.
Results: The mean age was 34 (32-37) years, with 2 (1-4) failed IVF cycles. Positive markers were reported in 95%, with 85% carrying two or more mutations. The most frequent mutation was hyperhomocisteinemia, present in 90%, followed by PAI 1 in 80%. The mutations were heterozygous in 70% and homozygous in 30%.
Conclusions: The reported correlation between genetic markers for thrombophilia and failed IVF is of 20-68%. Our results show that the frequency and type of mutation differs from what has been previously published for other study groups. The causal relationship and secondary implications are enough to suggest the need for more studies, diagnostic measures and early therapeutic options.
REFERENCES
Carranza-Lira S. Fundamentos de Endocrinología Ginecológica y Reproductiva. MDM; 2003.
Geva E, Amit A, Lerner-Geva L, Azem F, Yovel I, Lessing JB. Autoimmune disorders: Another possible cause for in-vitro fertilization and embryo transfer failure. Hum Reprod 1995; 10: 2560–2563.
Gopel W, Ludwig M, Junge AK, Kohlmann T, Diedrich K and Moller J. Selection pressure for the factor-V-Leiden mutation and embryo implantation. Lancet 2001; 358: 1238–1239.
Grandone E, Colaizzo D, Lo Bue A, Checola MC, Cittadini E, Margaglione M. Inherited thrombophilia and in-vitro fertilization implantation failure. Fertil Steril 2001; 76: 201–202.
Kaider BD, Price DE, Roussev RG, Coulam CB. Antiphospholipidantibody prevalence in patients with IVF failure. Am J Reprod Immunol 1996; 35: 388–393.
Edwards G, Brody S. Principles and Practice of Assisted Human Reproduction. Philadelphia, PA: WB Saunders; 1995.
Blumenfeld Z, Brenner B. Thrombophilia-associated pregnancy wastage. Fertil Steril 1999; 72: 765-774.
Lockwood CJ, Rand JH. The immunobiology and obstetrical consequences of antiphospholipid antibodies. Obstet Gynecol Surv 1994; 49: 432–441.
Martinelli I, Taioli E, Ragni G, Levi-Setti P, Passamonti SM, Battaglioli T, Lodigiani C, Mannucci PM. Embryo implantation after assisted reproductive procedures and maternal thrombophilia. Haematologica 2003; 88: 789–793.
Azem F, Many A, Yovel I, Amit A, Lessing JB, Kupferminc MJ. Increased rates of thrombophilia in women with repeated IVF failure. Hum Reprod 2004; 19: 368–370.
Coulam CB, Kaider BD, Kaider AS, Janowicz P, Roussev RG. Antiphospholipid antibodies associated with implantation failure after IVF/ET. J Assist Reprod Genet 1997; 14: 603–608.
Coulam CB, Jeyemdran RS, Fishel LA, Roussev R. Multiple thrombophilic gene mutations are risk factors for implantation failure. Reprod Biomed Online 2006; 12: 322–327.
Matsubayashi H, Arai T, Izumi S, Sugi T, Mclntyre JA, Path FRC, Makino T. Anti-annexin V antibodies in patients with early pregnancy loss or implantation failures. Fertil Steril 2001; 76: 694–699.
Nelen WLDM, Bulten J, Steegers EAP, Blom HJ, Hanselaar AGJ, Eskes TKAB. Maternal homocystine and chorionic vascularization in recurrent early pregnancy loss. Hum Reprod 2000; 15: 953–960.
Qublan HS, Malkawi HY, Tahat YA, Areidah S, Nusair B, Khreisat BM, Al- Quraan G, Abu-Assaf A, Hadaddein MF, Abu-Jassar H. In-vitro fertilization treatment: Factors affecting its results and outcome. J Obstet Gynaecol 2005; 25: 689–693.
Raziel A, Kornberg Y, Friedler S, Schachter M, Sela BA, Ron-El R. Hypercoagulable thrombophilic defects and hyperhomocystinemia in patients with recurrent pregnancy loss. Am J Reprod Immunol 2001; 45: 65–71.
Rey E, Kahn SR, David M, Shrier I. Thrombophilic disorders and fetal loss: A meta-analysis. Lancet 2003; 361: 901–908.
Sanson BJ, Friederich PW, Simioni P, Zanardi S, Hilsman MV, Girolami A, ten Cate JW, Prins MH. The risk of abortion and stillbirth in antithrombin-, protein C-, and protein S-deficient women. Thromb Haemost 1996; 75: 387–388.
Alonso A, Soto I, Urgelles MF, Corte JR, Rodriguez MJ, Pinto CR. Acquired and inherited thrombophilia in women with unexplained fetal losses. Am J Obstet Gynecol 2002; 187: 1337-1342.
Glueck CJ, Awadalla SG, Phillips H, Cameron D, Wang P, Fontaine RN. Polycystic ovary syndrome, infertility, familial thrombophilia, familial hypofibrinolysis, recurrent loss of in vitro fertilized embryos, and miscarriage. Fertil Steril 2000; 74: 39-397.
Yen JB. Reproductive Endocrinology. Philadelphia, PA: WB Saunders; 2001.
Nelen WL, Blom HJ, Steegers EA, den Heijer M, Eskes TK. Hyperhomocysteinemia and recurrent early pregnancy loss: a meta-analysis. Fertil Steril 2000; 74: 1196-1199.
Rey E, Kahn SR, David M, Shrier I: Thrombophilic disorders and fetal loss: a meta-analysis. Lancet 2003; 361: 901-908.
Dizon-Townson DS, Meline L, Nelson LM, Varner M, Ward K. Fetal carriers of the factor V Leiden mutation are prone to miscarriage and placental infarction. Am J Obstet Gynecol 1997; 177: 402-425.
Kupferminc MJ, Eldor A, Steinman N, Many A, Bar-Am A, Jaffa A, Fait G, Lessing JB. Increased frequency of genetic thrombophilia in women with complications of pregnancy. N Engl J Med 1999; 340: 1584-1589.
Sarig G, Younis JS, Hoffman R, Lanir N, Blumenfeld Z, Brenner B. Thrombophilia is common in women with idiopathic pregnancy loss and is associated with late pregnancy wastage. Fertil Steril 2002; 77: 342-347.