Successful fertility management of a patient with factor V deficiency: planned transfusion of fresh frozen plasma under infertility treatment

Expecting the unexpected: Acquired haemophilia A in a patient with homozygous factor V deficiency

“…This initial discrepancy between the severity of her biochemical defect and her mild bleeding phenotype is a recognized feature of FV deficiency . Although the bleeding pattern typically affects the skin, mucous membranes and soft tissues, spontaneous haematoperitoneum following ovulation has been reported in FV deficiency on at least two occasions . Similar to these previous cases, she was started on combined oral contraception (COCP) to prevent ovulation but in her early twenties she stopped taking the COCP because she wanted to conceive.…”

The use of fresh frozen plasma for reproduction in severe factor V deficiency

“…Advanced planning, in addition to a good understanding and awareness of the potential complications, are essential in ensuring an optimal outcome. Iwase et al, in 2011, reported the first successful pregnancy in a woman with severe FV deficiency after controlled ovarian stimulation with hMG and IUI under the prophylactic use of FFP [6]. Their patient underwent five treatment cycles before achieving a pregnancy that ended in spontaneous abortion.…”

“…Finally, the present case underwent a single cycle with ovulation induction, prophylactic FFP, and IUI, which produced the successful pregnancy. With respect to ovulation-related hemoperitoneum in FV deficiency requiring treatment, only three cases have been reported in the literature [6].…”

“…Due to the rarity of this disorder and the small number of cases reported in the literature, information on its clinical presentation and management are limited [3,4]. With respect to FV deficiency in reproductive-aged women, there are case reports describing pregnancy outcomes in approximately 30 women [5], and one case report of successful pregnancy following several cycles of ovulation induction and intrauterine insemination [6]. The authors report an additional case, where a woman with severe FV deficiency delivered twins after prophylactic fresh frozen plasma (FFP) administration, ovulation induction, and intrauterine insemination (IUI).…”