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Hum. Reprod. Advance Access published online on July 11, 2006
Human Reproduction, doi:10.1093/humrep/del203
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received March 23, 2006
Revised April 20, 2006
Accepted May 10, 2006

Article

Acquired and inherited thrombophilia: implication in recurrent IVF and embryo transfer failure

Hussein S. Qublan 1 *, Suhair S. Eid 2, Hani A. Ababneh 3, Zouhair O. Amarin 4, Aiman Z. Smadi 1, Farakaid F. Al-Khafaji 5, and Yousef S. Khader 6

1 Department of Obstetrics and Gynecology, Irbid, Jordan
2 Department of Coagulation and Hematology, Irbid, Jordan
3 Department of Immunology, Royal Medical Services, Jordan Armed Forces, Irbid, Jordan
4 Department of Obstetrics and Gynecology, Jordan University of Science and Technology, Irbid, Jordan
5 Department of Clinical Chemistry, Royal Medical Services, Jordan Armed Forces, Irbid, Jordan
6 Department of Public Health and Community Medicine, Jordan University of Science and Technology, Irbid, Jordan

* To whom correspondence should be addressed.
Hussein S. Qublan, E-mail: hqublan{at}yahoo.com


  Abstract

BACKGROUND: The objective of this study was to determine the incidence of undiagnosed thrombophilic factors and its relation to IVF and embryo transfer failure in women who have had three or more previous IVF-embryo transfer cycles. METHODS: The study group comprised of 90 consecutive women with three or more previously failed IVF-embryo transfer cycles (group A). Two control groups were enrolled: group B (n = 90) included women who have had successful pregnancy after their first IVF-embryo transfer cycle, and group C (n = 100) included women who conceived spontaneously with at least one uneventful pregnancy and no previous history of miscarriage. All women were tested for the presence of inherited [factor V Leiden (FVL) mutation, prothrombin mutation, meth-ylenetetrahydrofolate reductase (MTHFR) mutation and deficiencies in proteins S and C and antithrombin III] or acquired (lupus anticoagulant and anticardiolipin) thrombophilic factors. RESULTS: An increase in the incidences of FVL, MTHFR and antiphospholipid antibodies was found in the study group compared with the two control groups. At least one inherited or acquired thrombophilic factor was detected in 68.9% of women with repeated IVF failure compared with 25.6 and 25% in the groups B and C, respectively (P < 0.01). Combined thrombophilia (two or more thrombophilic factors) was significantly higher in women who have had repeated IVF failure as compared with the two control groups (35.6 versus 4.4 and 3%) (P < 0.0001). CONCLUSION: Thrombophilia has a significant role in IVF-embryo transfer implantation failure. Women with repeated IVF-embryo transfer failure should be screened for thrombophilia.

Keywords: implantation failure/IVF/thrombophilia.
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