THE MANAGEMENT OF WOMEN WITH THROMBOPHILIA IN PREPARATION FOR IN VITRO FERTILIZATION

The aim was to study changes in the hemostatic system in women with hereditary and acquired thrombophilia in IVF cycle, the possibility of their drugs correction, as well as the effect of this therapy on the outcome of IVF. We examined 119 women with congenital or acquired thrombophilia during preparation or during IVF cycle. In the presence of abnormalities in laboratory data, combination of weight adjusted dose of the low molecular weight heparin, low dose aspirin and folic acid administered to the severity of coagulation disorders and homocystein level. In the group of patients with a history 3 or more IVF failures APS was diagnosed in 36.6 % of women. In this group the frequency of mutations in genes: PAI-1, PLAT, fibrinogen was significantly higher than in control group (83.3 % and 58.33 %, 40 % and 19.44 %, 50 % and 25 % respectively, p < 0.05), as well as mutations in genes PAI-1 and PLAT combination rate (31.03 % and 13.89 % respectively, p < 0,05) and the frequency of combinations of 3 or more mutations (65.51 % and 19.44 %, p < 0.001). In the group of women with thrombophilia (n = 97) treated with this therapy 52.57 % IVF cycles was successful. At 36.08 % pregnancies ended with childbirth. In the subgroup of women with 3 or more IVF failures (n = 26) the pregnancy rate was 38.46 %.