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Hum. Reprod. Advance Access published online on December 10, 2007
Human Reproduction, doi:10.1093/humrep/dem383
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© The Author 2007. 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

The role of thrombophilia and thyroid autoimmunity in unexplained infertility, implantation failureand recurrent spontaneous abortion

José Bellver1,6, Sergio R. Soares2, Claudio Álvarez3, Elkin Muñoz4, Alberto Ramírez5, Carmen Rubio1, Vicente Serra1, José Remohí1 and Antonio Pellicer1

1 Instituto Valenciano de Infertilidad (IVI), University of Valencia, Plaza de la Policía Local, 3, 46015 Valencia, Spain 2 IVI Lisbon, Portugal 3 IVI Santiago de Chile, Chile 4 IVI Vigo, Spain 5 IVI México D.F., Mexico

6 Correspondence address. Tel: +34-963050900; Fax: +34-963050999; E-mail: jbellver{at}ivi.es

BACKGROUND: The role of thrombophilia and thyroid autoimmunity in unexplained infertility (UI), implantation failure (IF) and recurrent spontaneous abortion (RSA) is controversial and poorly understood.

METHODS: From March, 2004 to January, 2007, 119 women were prospectively included: 32 oocyte donors, 31 patients with UI, 26 with IF and 30 with RSA. The IF and RSA groups presented normal preimplantation genetic screening. Protein C, protein S, antithrombin III, lupus anticoagulant, activated protein C resistance (APCR), immunoglobulin M and G anticardiolipin antibodies, homocystine, Factor V Leiden, prothrombin G20210A mutation, methylentetrahydrofolate reductase C677T mutation, thyroid-stimulating hormone (TSH), free thyroxine, anti-thyroid peroxidase (TPO) and anti-thyroglobulin (TG) antibodies were assessed.

RESULTS: The prevalence of thrombophilia was high and similar among groups. In the IF group, the prevalence of APCR (15.4%), lupus anticoagulant (11.5%) and combined thrombophilia (19.2%) was higher, but not significantly different, than the other three groups. The prevalence of thyroid autoimmunity in women with IF (anti-TPO antibodies, P = 0.009; anti-TPO plus anti-TG antibodies,P = 0.04) and UI (anti-TPO, P = 0.002; anti-TG, P = 0.019; anti-TPO plus anti-TG antibodies, P = 0.005) was significantly increased in comparison to those with RSA. There was also a trend towards a higher prevalence of thyroid autoimmunity in the UI and IF groups than in the control group. TSH and free thyroxine levels all remained within a normal range.

CONCLUSIONS: When embryo aneuploidy is ruled out, thrombophilia could constitute an etiologic factor in IF. Furthermore, thyroid autoimmunity is strongly related to UI and IF.

Key words: thrombophilia/thyroid autoimmunity/recurrent spontaneous abortion/implantation failure/unexplained infertility

Submitted on July 24, 2007; resubmitted on October 24, 2007; accepted on November 2, 2007.


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This article has been cited by other articles:


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G. Ricci and R. Simeone
Thrombophilic screening in clinical practice should be evidence-based
Hum. Reprod., November 1, 2008; 23(11): 2609 - 2609.
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Home page
 Hum ReprodHome page
J. Bellver and S. R. Soares
Reply: Thrombophilic screening in clinical practice should be evidence-based
Hum. Reprod., November 1, 2008; 23(11): 2610 - 2611.
[Full Text] [PDF]


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