Background: The use of combined oral contraceptives (COC) has been associated with hypercoagulability. Through the analysis of the parameters of the thrombin generation test (TGT) it is possible to gain a better understanding of the relationship between use of hormones and hemostatic disorders.

Aims: To evaluate the profile of thrombin generation in women using or not combined oral contraceptives.

Methods: The study included young, healthy, university Brazilian women aged between 18 and 30 years using combined oral contraceptives (COC, n = 20) or not (non-COC, n = 20), of whom a sample of blood was collected. TGT was performed according to the CAT method, with low (LTF) and High (HTF) Tissue Factor, with subsequent analysis of the parameters Lagtime, Time to peak, Peak, Endogen Thrombin Potential (ETP).

Results: An increase in thrombin generation was observed in women using COC compared to women not using this drug, with greater discrimination between the two groups when the TGT was performed with LTF, as follows:  Peak (COC x non- COC: 456 ± 141 x 279 ± 122 nM; p = 0.001), and ETP (COC x non-COC: 2006.0 ± 431.0 x 1443.0 ± 350.3 nM.min; p <0.001) and Lagtime [COC x non-COC: 2.3 (1.1) x 3.5 (3.0) min .; p = 0.019] and Time to peak [COC x non-COC: 4.3 (1.2) x 6.5 (6.0) min; p = 0.022]. Confirming previous findings, this increase in thrombin generation is related to the use of OC that triggers an increase in procoagulants (factors VII, VIII, X and fibrinogen) and a decrease in natural anticoagulants (AT, PC, PS and TFPI).

Conclusions: Our results reinforce the importance of seeking the standardization and validation of TGT, a tool with great potential for application to assess hypercoagulable states in women using COC, among numerous diseases and other conditions related to hemostatic disorders.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/thrombin-generation-test-and-use-of-combined-oral-contraceptive/