Thrombophilia and outcomes of assisted reproduction technologies: a systematic review and meta-analysis

Di Nisio, Marcello; Rutjes, Anne W S; Ferrante, Noemi; Tiboni, Gian Mario; Cuccurullo, Franco; Porreca, Ettore (2011). Thrombophilia and outcomes of assisted reproduction technologies: a systematic review and meta-analysis. Blood, 118(10), pp. 2670-2678. Washington, D.C.: American Society of Hematology 10.1182/blood-2011-03-340216

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Thrombophilia has been associated with pregnancy complications and recurrent miscarriage. The aim of this systematic review was to evaluate the controversial association between thrombophilia and failures of assisted reproduction technology (ART). A systematic search of the literature for studies reporting on thrombophilia in women undergoing ART up to April 2011 yielded 33 studies (23 evaluating anti-phospholipid antibodies, 5 inherited thrombophilia, and 5 both) involving 6092 patients. Overall, methodologic quality of the studies was poor. Combined results from case-control studies showed that factor V Leiden was significantly more prevalent among women with ART failure compared with fertile parous women or those achieving pregnancy after ART (odds ratio = 3.08; 95% confidence interval, 1.77-5.36). The prothrombin mutation, methylenetetrahydrofolate reductase mutation, deficiency of protein S, protein C, or anti-thrombin were all not associated with ART failure. Women with ART failure tested more frequently positive for anti-phospholipids antibodies (odds ratio = 3.33; 95% confidence interval, 1.77-6.26) with evidence of high degree of between-study heterogeneity (I(2) = 75%; P < .00001). Prospective cohort studies did not show significant associations between thrombophilia and ART outcomes. Although case-control studies suggest that women experiencing ART failures are more frequently positive for factor V Leiden and anti-phospholipid antibodies, the evidence is inconclusive and not supported by cohort studies.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Rutjes, Anne




American Society of Hematology




Factscience Import

Date Deposited:

04 Oct 2013 14:22

Last Modified:

17 Sep 2015 09:47

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URI: (FactScience: 212887)

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