Birth of a child conceived using assisted reproductive technology in a woman with recurrent miscarriage and combined form of thrombophilia

Kraevaya E.E., Kirsanova T.V., Shmakov R.G.

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia

Relevance: Ovarian stimulation and hormone therapy in assisted reproductive technology (ART) programs are accompanied by procoagulant changes in the hemostasis system. The changes in patients with thrombophilia may be more severe and lead to thrombosis, as well as possibly reduce the frequency of embryo implantation and have a negative impact on the course of pregnancy, resulting in spontaneous miscarriages, preeclampsia, and fetal growth retardation.
Case report: A 40-year-old patient with a bad obstetric history was admitted to the Department of Assisted Reproductive Technologies in the Treatment of Infertility of the National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Moscow, Russia. Her history included 5 miscarriages in early pregnancy; she also experienced a combined form of thrombophilia: heterozygous factor V Leiden mutation, antiphospholipid syndrome, and JAK2-positive essential thrombocythemia. After providing preconception care, ART treatment, and combined therapy for hemostatic disorders in the pregnancy planning stage and during pregnancy, it was possible to deliver a live full-term baby.
Conclusion: Timely and complete examination, administration of proper complex therapy to women with recurrent miscarriage and thrombophilia may increase the effectiveness of ART treatment and improve reproductive outcomes. Thrombophilia as a risk factor for thromboembolic complications in ART treatment, as well as reproductive losses, is a subject of further study and discussion due to the ambiguous data on the safety and effectiveness of modern therapeutic approaches to this issue.

Authors’ contributions: Kraevaya E.E., Kirsanova T.V. – writing the text; Kirsanova T.V., Shmakov R.G. – editing the article.
Conflicts of interest: Authors declare lack of the possible conflicts of interests.
Funding: The study was conducted without sponsorship.
Ethical Approval: The study was approved by the Ethical Review Board of the Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
Patient Consent for Publication: The patient provided an informed consent for the publication of her data.
For citation: Kraevaya E.E., Kirsanova T.V., Shmakov R.G. Birth of a child conceived using assisted reproductive technology in a woman with recurrent miscarriage and combined form of thrombophilia.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (1): 154-158 (in Russian)
https://dx.doi.org/10.18565/aig.2023.224

Keywords

assisted reproductive technology
thrombophilia
antiphospholipid syndrome
hereditary thrombophilia
thrombocythemia
low molecular weight heparins
acetylsalicylic acid

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Received 25.09.2023

Accepted 16.10.2023

About the Authors

Elizaveta E. Kraevaya, Ph.D., Researcher of the Department of Assisted Reproductive Technologies in Treating Sterility, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, +7(495)531-44-44, e_kraevaya@oparina4.ru, 4 Oparin str.,
117997, Moscow, Russia, https://orcid.org/0000-0002-8140-0035
Tatiana V. Kirsanova, Ph.D., Leading Researcher at the Department of Reproductive Hematology and Clinical Hemostasiology, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, +7(495)531-44-44, t_kirsanova@oparina4.ru, 4 Oparin str.,
117997, Moscow, Russia, https://orcid.org/0000-0002-6125-590Х
Roman G. Shmakov, Dr. Med. Sci., Professor of the Russian Academy of Sciences, Chief specialist in obstetrics of the Russian Ministry of Health, Director of the Institute of Obstetrics, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, +7(495)531-44-44, r_shmakov@oparina4.ru, 4 Oparin str., 117997, Moscow, Russia, https://orcid.org/0000-0002-2206-1002

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