Abstract Number: PB2547
Meeting: ISTH 2020 Congress
Background: The factors of success of assisted reproductive technologies (ART) are known: the quality of embryos, endometrial receptivity, and hemostasis (fibrinolysis) which plays an important role in the regulation of the implantation process. Hypofibrinolysis is a known cause of failures in ART. But some patients with ART failures show a state of hypocoagulation and hemorrhagic complications.
Aims: to study the state of the fibrinolysis system of women with a history of ART failures during ART procedure, to evaluate the effectiveness of drugs that affect hemostasis in ART cycle in order to increase the frequency of pregnancy.
Methods: A prospective single-center research included 130 patients with a history of ART failures who were planning pregnancy using ART method. The approval of the local ethics Committee was obtained, patients signed an informed consent. Evaluation of the fibrinolysis system (D-dimer, XIIa-dependent fibrinolysis) and thrombodynamics (TD) were monitored at the stages: 2-3 days after oocyte puncture or 3-4 days before cryoembryon transfer, and then 2-3 days, 4-5 days, and 8-9 days after embryo transfer. Low-weight-molecular heparins (LWMH) were prescribed in hypercoagulation / hypofibrinolysis, and tranexamic acid (TA) in hypocoagulation / hyperfibrinolysis.
Results: The analysis included 111 patients. 140 embryo transfers were performed, including 68 transfers of cryoembryos. Pregnancy was achieved in 43.6% cases. In 80% protocols LWMH was prescribed and pregnancy occurred in 41% cases. In 18.6% protocols TA was prescribed and pregnancy occurred in 53,8% patients. 2 women refused to take medication. Cut-off points are determined based on tests: for the Vst and D parameters in the TD and the fibrinolysis system parameters to make a decision about the choice of the drug (LWMH or TA) at the point of study before embryo transfer.
Conclusions: Controlled fibrinolysis is a possible strategy for increasing the frequency of pregnancy in ART programs.
To cite this abstract in AMA style:Safiullina S, Vuimo T, Kotova Y, Ilizarova N. Disorders in the Fibrinolytic System as a Possible Factor in the Failure of Assisted Reproductive Technologies [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/disorders-in-the-fibrinolytic-system-as-a-possible-factor-in-the-failure-of-assisted-reproductive-technologies/. Accessed March 3, 2021.
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