Venous thrombosis during assisted reproduction: novel risk reduction strategies.

Abstract:

:Ovarian hyperstimulation syndrome (OHSS) affects 5% of IVF cycles and incurs a 100-fold increase in risk of venous thrombosis over natural conceptions. Identification of women at risk of OHSS can be achieved using antral follicle count (AFC) and anti-Müllerian hormone (AMH). For those women with a high AFC or AMH combining a GnRH antagonist with a conventional hCG trigger will reduce the risk of OHSS and still allow a fresh transfer to occur. Complete abolition of OHSS is however now a reality by avoiding exposure to exogenous hCG. This can be achieved by segmentation of the IVF cycle using a GnRH agonist for final oocyte maturation and then freezing all oocytes or embryos with subsequent replacement of a single embryo in the context of a frozen embryo transfer. This novel approach will ensure a VTE risk equivalent to natural conception and can be combined with conventional thromboprophylaxis strategies.

journal_name

Thromb Res

journal_title

Thrombosis research

authors

Nelson SM

doi

10.1016/S0049-3848(13)00023-6

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

S1-3

eissn

0049-3848

issn

1879-2472

pii

S0049-3848(13)00023-6

journal_volume

131 Suppl 1

pub_type

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