Abstract Number: LPB0044
Meeting: ISTH 2021 Congress
Background: Controlled ovarian stimulation (COS) for assisted reproductive techniques (ART) is associated with a hypercoagulable state and an increased risk of venous thrombosis. The impact of the different ART protocols on coagulation biomarkers is unknown.
Aims: To assess the evolution of coagulation biomarkers throughout and after the ovarian stimulation comparing 3 different ART protocols.
Methods: In this observational multicentre cohort study, infertile women undergoing COS for ART in 2017-2019 were included. Written informed consent was obtained and the study was approved by the ethics committees. Our primary outcome was endogenous thrombin potential (ETP) assessed by calibrated automated thrombinography (using 5 pM of tissue factor). ETP was measured before stimulation (baseline), on the day of ovulation triggering (triggering) and seven days after triggering. Three protocols were prescribed according to the standards used: agonist protocol with hCG trigger (ag-hCG); antagonist protocol with hCG trigger (atg-hCG) or GnRH agonist trigger (atg-GnRH); evolution of ETP was estimated and compared among groups using mixed effects linear regression model.
Results: A total of 64 women, mean aged (SD) 37.8 (2.8), participated to the study: 24 received ag-hCG, 16 atg-hCG, and 24 atg-GnRH. The mean serum estradiol levels in atg-GnRH were statistically higher at trigerring and lower 7days after. Overall, ETP evolution over time was statistically different between groups (p=0.013). If values were similar at baseline and increased at triggering in each group, the greatest difference occurred between triggering and 7days after triggering: while ETP continued to increase in ag-hCG (+110) and atg-hCG (+170), it remained stable in atg-GnRH (+0). Protein C and protein S levels were stable, while D-dimers, fibrinogen and factor VIII increased at triggering and 7days after in all groups.
Conclusions: The hypercoagulable state was higher and persistent after stimulation in the ag-hCG and atg-hCG groups groups compared to the atg-GnRH group.
To cite this abstract in AMA style:Hugon-Rodin J, Casini A, Bénard J, Poncet A, Fontana P, Vulliemoz N, Streuli I. Prothrombotic Biomarkers during Controlled Ovarian Stimulation for Assisted Reproductive Techniques [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/prothrombotic-biomarkers-during-controlled-ovarian-stimulation-for-assisted-reproductive-techniques/. Accessed November 29, 2021.
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