Effect of heparin on recurrent IVF-ET failure patients

Abstract

Objective: To elucidate the possible role of unfractionated heparin in patients with failed repeated in in vitro fertilization and embryo transfer (IVF-ET) and thrombophilia.

Methods: This case control study evaluated the efficacy of the unfractionated heparin in increasing the pregnancy and implantation ratio in women with recurrent IVF-ET failures. Eighty-six women received in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) with a record of three or more previous IVF-ET failures. Participants were randomly distributed into two groups. Group A (n=43) received unfractionated heparin 5 000 IU twice daily, and group B (n=43) did not take any antithrombotic drugs. Coagulation abnormalities such as factor V Leiden (FVL) mutation, methylene tetra hydro folate reductase (MTHFR) mutation and prothrombin mutation (FII) were evaluated. Age, body mass index, basal follicular stimulating hormone, basal estradiol, duration of infertility, and number of IVF-ET failures were compared between two groups.

Results: 45.0% and 17.4% of women were pregnant with and without MTHFR and prothrombin mutation, respectively, when they received unfractionated heparin treatment. The implantation rate was more in group A (12.5%) than group B (4.3%) and differences in the fertilization rate of the two groups were observed (27.7% vs. 35.9%). The clinical pregnancy rate per cycle was remarkably more in group A (30.2%) than group B (14.0%).

Conclusions: Heparin is a safe and valuable treatment for patients with repeated IVF-ET failures. The clinical pregnancy and implantation rates are higher in the heparin-treated group in contrast with the control group.

Keywords

Heparin / Recurrent implantation failure / Thrombophilia / MTHFR C677T / Prothrombin A20210G / Factor Ⅴ Leiden

Conflict of interest statement

All the authors declare that there are no conflicts of interest.

Acknowledgments

The authors would like to thank Mr. Babakhanzade and the members who will take part in this study as well as the Abortion Research Centre at Shahid Sadoughi University of Medical Sciences for their beneficial support. And our research group would like to thank the patients and their families for their cooperation.

Funding

The study received no extramural funding.

Authors’ contributions

Maryam Shirmohamadi performed the main steps of the manuscript and writing of the manuscript. Mehri Mashayekhy, Iraj Alipourfard, and Javad Fazeli collected the samples and helped to achieve restriction fragment length polymorphism. Nasrin Ghasemi, head of team, monitored and fixed technical errors during all study steps. The authors read and approved the final manuscript.

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