Thromboembolic complications associated with reproductive endocrinologic procedures

This article provides a brief overview of what is known about how the blood coagulation system is affected by hormonal ovarian stimulation and ovulation induction in the context of artificial reproductive techniques. Virchow's classic definition of thrombosis is contemplated and the historical role of estrogens is addressed with special reference to their impact on the vascular wall, the vascular tone, and blood flow behavior and their association with the release of factor VII from platelet-activated granulocytes. The role of protein C, protein S, and antithrombin ill is discussed in the context of ovarian hyperstimulation (OHS) alluding to the central role that in OHS has to be attributed to human choriogonadotropin rather than to estrogens. Thoughts on the management of OHS are briefly shared.