Prior Thromboembolic Disease and Assisted Reproductive Therapy

Abstract

Assisted reproductive therapy (ART) increases the risk of venous thrombosis (VT) by 2- to 4-fold, whereas pregnancy increases the risk by 5- to 10-fold. Women with a history of VT undergoing ART are often suggested thromboprophylaxis. The literature is scarce and international guidelines are lacking. We made a review of the literature and base our suggestions primarily on expert opinions. We suggest women with a prior VT to use low-molecular-weight heparin as thromboprophylaxis starting from ovarian stimulation, throughout pregnancy, and 6 weeks postpartum. Assessment of VT risk should be done prior to ART. Adjustment of treatment to minimize the thrombotic risk, such as preventing ovarian hyperstimulation syndrome, single-embryo transfer, cryopreservation, and transfer of frozen embryos instead of fresh embryo in high-risk women, is suggested. Women with previous arterial thrombosis should continue aspirin during ART treatment, pregnancy, and postpartum.

Efeitos do tratamento com agentes antitrombóticos em fêmeas de camundongos grávidas após lesão arterial induzida com cloreto férrico na carótida e a influência destes no desenvolvimento da prole

“…A fase de iniciação ocorre logo Outros estudos descrevem que os casos de tromboembolismo são mais recorrentes durante o terceiro trimestre da gestação [19,20]. Outros estudos observacionais mais recentes, apontam um aumento de casos de tromboembolismo em gestantes submetidas às novas tecnologias de reprodução assistida quando comparadas com as gestações ocorridas de forma espontânea [21,22]. Giannubilo et al Pesquisas sobre fatores de risco durante a gravidez, destacam algumas comorbidades que amplificam o risco de eventos tromboembólicos.…”