Journal
JOURNAL OF REPRODUCTIVE IMMUNOLOGY
Volume 153, Issue -, Pages -Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.jri.2022.103674
Keywords
Antiphospholipid antibodies; In vitro fertilization; Aspirin; Low molecular weight heparin
Categories
Funding
- National Nature and Science Foundation of China [81730041, 81401265, 81401267]
- National Key Research and Development Program of China [2021YFC2700402]
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This study found that anticoagulant therapy can significantly improve live birth rate, pregnancy rate, and reduce miscarriage rate in infertile women with persistent aPL positive. Combination treatment of aspirin and LMWH showed better results compared to monotherapy. For high-risk aPL positive infertile population, aspirin plus LMWH adjuvant treatment is recommended.
Antiphospholipid (aPL) antibodies are more frequently detected among infertile women, but the association between aPL and in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcomes and whether need to get routine treatment are still controversial. The present study aims to find out whether infertile population with persistent aPL positive need treatment and which therapy is more effective. This retrospective study included 181 persistent aPL positive women, including 149 cases receiving anticoagulant treatment, either low -dose aspirin, low molecular weight heparin (LMWH) or aspirin plus LMWH adjuvant treatment (treated group), and 32 cases not receiving any treatment (untreated group). The treated group were further divided by com-bination therapy group (using both aspirin and LMWH,52 cases) and monotherapy group (only using aspirin, 76 cases). The live birth rate and other clinical outcomes, including pregnancy rate, implantation rate, ongoing pregnancy rate and miscarriage rate were compared. The results show anticoagulant therapy can significantly improve live birth rate (59.06 % VS 34.48 %, P = 0.019), implantation rate (59.64 % VS 46.15 %, P<0.001), ongoing pregnancy rate (59.73 % VS 34.38 %, P = 0.016), as well as reduce miscarriage rate (8.25 % VS 31.25 %, P<0.001). Combination treatment of aspirin and LMWH exerts a higher live birth rate than monotherapy (75.00 % VS 53.95 %, P = 0.026). Infertile women with aPL positive might be classified as high-risk and low-risk aPL profiles. Those high-risk aPL positive infertile populations should be identified during IVF/ICSI and given cor-responding thromboprophylaxis, and aspirin plus LMWH adjuvant treatment might be recommended.
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