Reduced protein C Global assay level in infertile women prior to IVF-ET treatment

Abstract

Purpose In the last few years more robust evidence is emerging to point out at an increased rate of prematurity and low birth weight in singleton pregnancies following ART. Whether this increased rate is related to ART practice or to infertility per se, is still an open question. Our aim in this study was to explore this question by evaluating Protein C (ProC) Global assay in infertile women before ART treatment. Methods A cohort of 95 unselected and consecutive infertile women, eligible for ART, was prospectively recruited for the study. The control group included 77 matched healthy fertile women with a history of spontaneous conceptions. Pro C Global assay was evaluated in both groups. A full thrombophilic work-up was performed in the study group.Results ProC Global assay level was found to be significantly lower in the study as compared to the control group, corresponding to 0.78 ± 0.16 and 0.88 ± 0.16, respectively (P <0.01). As well, abnormal ProC Global assay level of ≤0.8 was significantly higher in the study as compared to control group corresponding to 53 % and 29 %, respectively. ProC Global assay level was significantly lower in women within the study group found to have APCR, factor V Leiden and high factor VIII level, any thrombophilia or combined thrombophilia when compared to women without these thrombophilic risk factors. Conclusions Reduced ProC Global assay level is encountered in infertile women prior to ART treatment. This finding may suggest a unique anticoagulation Protein C pathway in infertile as compared to fertile women. Further studies are encouraged to explore this finding.

Reduced Protein C Global Assay Levels in Infertile Women with in vitro Fertilization Failure: A Pilot Study

“…The abnormally low protein C global levels were independent of patient age and BMI, as well as infertility duration and etiology, and these findings are in agreement with Younis et al [19]. The duration and cause of infertility did not seem to affect the results either.…”

“…It also verifies findings in a subsequent study by the same group [19 ]which reported that levels of protein C global assay were much more decreased in infertile women eligible for ART compared to fertile women who conceived naturally. The authors concluded that, before ART treatment, decreased protein C global levels are encountered in women with infertility.…”

“…The test was recently evaluated in women with spontaneous conception [18]. A few studies have evaluated protein C global assay prior to [19] or during pregnancy [17], but the test has not been previously evaluated in relation to the success or failure of ART. To the best of our knowledge, our study is the first to highlight a link between ART failure and abnormalities in the protein C pathway.…”

“…Few studies have examined protein C global assay levels in relation to ART in healthy women during pregnancy, in various trimesters of singleton pregnancies [17,18], and in infertile women prior to IVF [19], but its role in infertile women with IVF failure remains unclear. Therefore, the aim of this study was to assess the protein C global assay in infertile women with IVF failure compared to healthy fertile women in a trial to evaluate the results of this assay in relation to the success and failure of IVF.…”

Protein C Activity in Women With Unexplained Infertility

“…Many studies addressed the relation of hereditary thrombophilia and infertility especially cases related to assisted reproduction and repeated IVF failure. Reduced protein C global assay level was found in infertile women prior to assisted reproduction treatment, a finding suggesting unique anticoagulation protein C pathway in infertile compared to fertile women [17]. It has been established that the majority of placental vascular complications associated with thrombophilias during pregnancy have been related to the protein C pathway [10,18].…”