Management strategies for thrombophilic patients undergoing assisted reproductive technologies

Isenova S.Sh., Aripkhanova A.S., Sultanmuratova D.D., Kazybaeva A.S., Tileukul N.A., Boran A.M.

Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan

Objective: To summarize the current data on optimal thromboprophylaxis in thrombophilic women undergoing in vitro fertilization (IVF) and embryo transfer, primarily with a focus on strategies for preventing venous thromboembolism (VTE); to discuss the possibility of preventing pregnancy complications in pregnant women with thrombophilia.
Materials and methods: The databases and services, namely PubMed, Wiley, Scopus and Google scholar, have been searched for articles on thrombophilia and assisted reproductive technology-related pregnancy over the past 10 years. No restrictions were imposed on the design of the study. The search was carried out using MESH keywords.
Results: Hereditary thrombophilia is a genetic condition that increases the risk of thromboembolic diseases, especially during pregnancy. However, it is not recommended to have routine screening for hereditary thrombophilia in asymptomatic patients. Pregnant women with a previous history of VTE or with first-line relatives with this disease should be screened for thrombophilia genes. Low molecular weight heparins and acetylsalicylic acid are effective methods of thromboprophylaxis; anticoagulant therapy should start in the first trimester and continue in the postpartum period. The patients with antiphospholipid syndrome may have a high antibody titer, these patients should refrain from IVF until the antibody titer decreases. Immunosuppressive therapy is an effective method of reducing antibodies.
Conclusion: The history of repeated IVF failures and habitual miscarriage is not an indication for examination for thrombophilia genes; however, these women should be examined for the presence of antiphospholipid syndrome.

Authors’ contributions: Isenova S.Sh., Kazybayeva A.S. – developing the concept of the study; Sultanmuratova D.D. – developing the design of the study; Tileukul N.A., Boran A.M. – conducting the study; Isenova S.Sh. – interpreting the results of the study; Aripkhanova A.S. – writing the article.
Conflicts of interest: The authors declare no conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Isenova S.Sh., Aripkhanova A.S., Sultanmuratova D.D., Kazybaeva A.S., Tileukul N.A., Boran A.M. Management strategies for thrombophilic 
patients undergoing assisted reproductive technologies. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (11): 5-10 (in Russian)


assisted reproductive technologies (ART)
in vitro fertilization (IVF)
low molecular weight heparins


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Received 24.07.2023

Accepted 01.11.2023

About the Authors

Saule Sh. Isenova, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology, Kazakh National Medical University named after S.D. Asfendiyarov,
Almaty, Republic of Kazakhstan, +7(705)172-75-00,,
Aigerim S. Aripkhanova, 3rd year resident of obstetrics and gynecology, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan, +7(778)778-77-07,,
Dilfuza D. Sultanmuratova, assistant of the Department of Obstetrics and Gynecology, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty,
Republic of Kazakhstan, +7(778)742-02-09,,
Aigul S. Kazybaeva, Associate Professor, Department of Obstetrics and Gynecology, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty,
Republic of Kazakhstan, +7(701)392-99-33,,
Nurliaina A. Tileukul, 3rd year resident of obstetrics and gynecology, Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Republic of Kazakhstan, +7(701)102-96-84,,
Aisana M. Boran, 1st year resident of obstetrics and gynecology, Kazakh National Medical University. S.D. Asfendiyarov, Almaty, Republic of Kazakhstan, +7(775)279-67-76,,
Corresponding author: Dilfuza D. Sultanmuratova,

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