Birth of a child conceived using assisted reproductive technology in a woman with recurrent miscarriage and combined form of thrombophilia

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Abstract

Relevance: Ovarian stimulation and hormone therapy in assisted reproductive technology (ART) programs are accompanied by procoagulant changes in the hemostasis system. The changes in patients with thrombophilia may be more severe and lead to thrombosis, as well as possibly reduce the frequency of embryo implantation and have a negative impact on the course of pregnancy, resulting in spontaneous miscarriages, preeclampsia, and fetal growth retardation.

Case report: A 40-year-old patient with a bad obstetric history was admitted to the Department of Assisted Reproductive Technologies in the Treatment of Infertility of the National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Moscow. Her history included 5 miscarriages in early pregnancy; she also experienced a combined form of thrombophilia: heterozygous factor V Leiden mutation, antiphospholipid syndrome, and JAK2-positive essential thrombocythemia. After providing preconception care, ART treatment, and combined therapy for hemostatic disorders in the pregnancy planning stage and during pregnancy, it was possible to deliver a live full-term baby.

Conclusion: Timely and complete examination, administration of proper complex therapy to women with recurrent miscarriage and thrombophilia may increase the effectiveness of ART treatment and improve reproductive outcomes. Thrombophilia as a risk factor for thromboembolic complications in ART treatment, as well as reproductive losses, is a subject of further study and discussion due to the ambiguous data on the safety and effectiveness of modern therapeutic approaches to this issue.

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About the authors

Elizaveta E. Kraevaya

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Author for correspondence.
Email: e_kraevaya@oparina4.ru
ORCID iD: 0000-0002-8140-0035

Ph.D., Researcher of the Department of Assisted Reproductive Technologies in Treating Sterility

Russian Federation, 117997, Moscow, Oparina str., 4

Tatiana V. Kirsanova

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: t_kirsanova@oparina4.ru
ORCID iD: 0000-0002-6125-590X

Ph.D., Leading Researcher at the Department of Reproductive Hematology and Clinical Hemostasiology

Russian Federation, 117997, Moscow, Oparina str., 4

Roman G. Shmakov

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: r_shmakov@oparina4.ru
ORCID iD: 0000-0002-2206-1002

Dr. Med. Sci., Professor of the Russian Academy of Sciences, Chief specialist in obstetrics of the Russian Ministry of Health, Director of the Institute of Obstetrics

Russian Federation, 117997, Moscow, Oparina str., 4

References

  1. Jarne-Borràs М., Miró-Mur F., Anunciación-Llunell A., Alijotas-Reig J. Antiphospholipid antibodies in women with recurrent embryo implantation failure: a systematic review and meta-analysis. Autoimmun. Rev. 2022;21(6):1031. https://dx.doi.org/10.1016/j.autrev.2022.103101.
  2. Candeloro M., Di Nisio M., Ponzano A., Tiboni G., Potere N., Tana M. et al. Effects of obesity and thrombophilia on the risk of abortion in women undergoing in vitro fertilization. Front. Endocrinol. 2020;11:594867. https://dx.doi.org/10.3389/fendo.2020.594867.
  3. Бицадзе В.О., Акиньшина С.В., Андреева М.Д. Макацария А.Д. Тромбоэмболические осложнения, связанные с использованием вспомогательных репродуктивных технологий. Синдром гиперстимуляции яичников. Практическая медицина. 2013;7(13):20-31. [Bitsadze V.O., Akinshina S.V., Andreeva M.D., Makatsariya A.D. Thromboembolic complications related to the use of assisted reproductive treatment. Ovarian hyperstimulation syndrome. Practical Medicine. 2013;7(13):20-31. (in Russian)].
  4. Николаева М.Г., Смирнова А.А. Насколько велик риск развития тромбоэмболии в программах ЭКО? Проблемы репродукции. 2022;28(2):86-95. [Nikolaeva M.G., Smirnova A.A. How high is the risk of thromboembolism in IVF? Russian Journal of Human Reproduction. 2022;28(2):86-95. (in Russian)]. https://dx.doi.org/10.17116/repro20222802186
  5. Министерство здравоохранения Российской Федерации. Клинические рекомендации «Венозные осложнения во время беременности и послеродовом периоде. Акушерская тромбоэмболия». 2022. [Ministry of Health of the Russian Federation. Clinical guidelines "Venous complications during pregnancy and the postpartum period. Obstetric thromboembolism". 2022. (in Russian)].
  6. Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil. Steril. 2015;103(3):e9-e17. https://dx.doi.org/10.1016/j.fertnstert.2014.12.093
  7. ACOG. Thrombosis, Thrombophilia, and Thromboembolism. Clin. Updat. Women’s Heal. Care. 2016.
  8. Di Nisio М., Ponzano А., Tiboni G., Guglielmi M., Rutjes A.W.S., Porreca E. Effects of multiple inherited and acquired thrombophilia on outcomes of in-vitro fertilization. Thromb. Res. 2018;167:26-31. https://dx.doi.org/10.1016/ j.thromres.2018.05.006.
  9. Di Rosa R., Ferrero S., Cifani N., Ferri L., Proietta M., Picchianti Diamanti A., Del Porto F. In vitro fertilization and autoimmunity: Evidence from an observational study.Eur. J. Obstet. Gynecol. Reprod. Biol. 2019;234:137-42. https://dx.doi.org/10.1016/j.ejogrb.2018.12.042.
  10. Tektonidou M., Andreoli L., Limper M., Amoura Z., Cervera R., Costedoat-Chalumeau N. EULAR recommendations for the management of antiphospholipid syndrome in adults. 2019;78(10):1296-304. https://dx.doi.org/10.1136/annrheumdis-2019-215213.
  11. Акиньшина С.В., Макацария А.Д., Бицадзе В.О. Патогенез и профилактика тромбоэмболических осложнений, связанных с использованием вспомогательных репродуктивных технологий. Медицинский совет. 2014;(9):84-9. [Akinshina S.V., Makatsaria A.D., Bitsadze V.O. Pathogenesis and prevention of thromboembolic complications associated with the use of assisted reproductive technologies. Medical Council. 2014;(9):84-9. (in Russian)]. https://doi.org/10.21518/2079-701X-2014-9-84-89.
  12. Hugon-Rodin J., Casini A., Bénard J., Poncet A., Raverot V., Fontana P. et al. Prothrombotic biomarkers during controlled ovarian stimulation for assisted reproductive technology. Fertil Steril. 2023;119(6):976-84. https://doi.org/10.1016/j.fertnstert.2023.02.009.
  13. Краевая Е.Е., Долгушина Н.В., Менжинская И.В., Шпилюк М.А., Безнощенко О.С. Кречетова Л.В. Результаты программ вспомогательных репродуктивных технологий у пациенток с персистенцией антифосфолипидных антител. Акушерство и гинекология. 2020;4:97-103. [Kraevaya Е.Е., Dolgushina N.V., Menzhinskaya I.V., Shpilyuk М.А., Beznoshchenko О.S., Krechetova L.V. Outcomes of assisted reproductive technologies in patients with persistence оf antiphospholipid antibodies. Obstetrics and Gynecology. 2020;(4):97-103. (in Russian)]. https://dx.doi.org/10.18565/aig.2020.4.97-103
  14. Wu L., Fang X., Lu F., Zhang Y., Wang Y., Kwak-Kim J. Anticardiolipin and/or anti-β2-glycoprotein-I antibodies are associated with adverse IVF outcomes. Front. Immunol. 2022;13:986893. https://dx.doi.org/10.3389/fimmu.2022.986893.
  15. Министерство здравоохранения Российской Федерации. Приказ от 31 июля 2020 г. № 803н «О порядке использования вспомогательных репродуктивных технологий, противопоказаниях и ограничениях к их применению». [Ministry of Health of the Russian Federation. Order No. 803n dated July 31, 2020 "On the procedure for the use of assisted reproductive technologies, contraindications and restrictions to their use". (in Russian)].
  16. Меликян А.Л., Ковригина А.М., Суборцева И.Н., Шуваев В.А., Афанасьев Б.В., Агеева Т.А., Байков В.В., Виноградова О.Ю., Голенков А.К., Грицаев С.В., Зарицкий А.Ю., Капланов К.Д., Ломаиа Е.Г., Мартынкевич И.С., Морозова Е.В., Поспелова Т.И., Соколова М.А., Судариков А.Б., Туркина А.Г., Шатохин Ю.В., Савченко В.Г. Национальные клинические рекомендации по диагностике и терапии Ph-негативных миелопролиферативных заболеваний (истинная полицитемия, эссенциальная тромбоцитемия, первичный миелофиброз) (редакция 2018 г.). Гематология и трансфузиология. 2018;63(3):275-315. [Melikyan A.L., Kovrigina A.M., Subortseva I.N., Shuvaev V.A., Afanasiev B.V., Ageeva T.A., Baikov V.V., Vinogradova O.Yu., Golenkov A.K., Gritsaev S.V., Zaritskiy A.Yu., Kaplanov K.D., Lomaia E.G., Martynkevich I.S., Morozova E.V., Pospelova T.I., Sokolova M.A., Sudarikov A.B., Turkina A.G., Shatokhin Yu.V., Savchenko V.G. National сlinical recommendations for diagnosis and therapy of Ph-negative myeloproliferative neoplasms (polycythemia vera, essential thrombocythemia, primary myelofibrosis) (edition 2018). Russian journal of hematology and transfusiology. 2018;63(3):275-315. (in Russian)].

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