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Prevalence/Incidence of Hereditary and Acquired Thrombophilia Markers among Egyptian Females with Recurrent Pregnancy Loss or IVF Failure

Amin S, Issa H and Ramzy A

Background: The largest percentage of failed in vitro fertilization (IVF) cycles, are due to lack of implantation. As hereditary and acquired thrombophilia can cause in placentation failure, it may have a role in recurrent IVF failure.
Objective: Aim of this case-control study was to determine the most prevalent types of hereditary and acquired thrombophilia in women with recurrent IVF failures.
Materials and Methods: Case group comprised 2466 women, with a history of recurrent IVF failure. Control group was comprised of 531 men (Most prevalent DVT gender presented in our Clinics) suffering from Active DVT (To correlate the impact those factors IVF failure with an active thrombotic effect among the control group). All participants were assessed for the presence of inherited thrombophilias including: Factor V Leiden, methyl tetrahydrofolate reductase (MTHFR) mutation, prothrombin mutation, plasminogen activator inhibitor-1 (PAI-1) mutation, Factor XIII, ACE, HPA1, and APO E and the homocystein level, protein S and C deficiency, antithrombin III (AT-III) deficiency, lupus anti-coagulant, NK markers and anticardiolipin. Positive results are compared as regard most prevalent combinations.
Results: Having at least one thrombophilia known as a risk factor for recurrent IVF failure (95% CI=1.74-5.70, OR=3.15, p=0.00). Mutation of factor V Leiden (95% CI=1.26-10.27, OR=3.06, P=0.01) and homozygote form of MTHFR mutation (95% CI=1.55-97.86, OR=12.33, p=0.05) were also risk factors for recurrent IVF failure. However, we could not find significant difference in other inherited thrombophilia’s.
Conclusion: Inherited thrombophilia is as prevalent in women with recurrent IVF failure compared men with multiple DVT. Homozygous APO E and ACE as well as heterozygous ACE, MTHFR A and PAI contribute as a major factor in patients with recurrent failure.