Ishod trudnoća nakon IVF-a u žena s trombofilijom

master's thesis

• Title (english): Pregnancy outcome after IVF in patients with trombophilia
• Author: Krešimir Crljenko
• Mentor: Marina Šprem Goldštajn (mentor)
• Committee member: Miro Kasum (predsjednik povjerenstva)
• Committee member: Dinka Pavičić-Baldani (član povjerenstva)
• Committee member: Marina Šprem Goldštajn (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Metode potpomognute oplodnje kao što su IVF ili ICSI, nude mogućnost začeća neplodnim parovima. Međutim, neuspjeh implantacije prenesenog embrija u endometrij maternice ostaje velik problem i zbog toga prosječno svega 30% embrio transfera rezultira živorođenim djetetom. Mehanizmi odgovorni za visoku stopu neuspjeha IVF-a većinom su nerazjašnjeni i nepoznati. U zadnje vrijeme tema brojnih znanstvenih radova bila je povezanost neuspjeha IVF-a s hiperkoagulabilnošću krvi kao posljedice trombofilija. Trombofilije mogu biti nasljedne i stečene, a najčešće među njima su mutacije gena za proteine koji sudjeluju u kaskadnim koagulacijskim procesima kao što su mutacija FVL i mutacija gena za protrombin. Nasljedne trombofilije razmjerno su čest poremećaj, s najvišom prevalencijom među bijelom rasom koja, ovisno o istraživanju, iznosi i više od 15%.
Rezultati istraživanja koji se bave ovom tematikom kontradiktorni su. Objedinjeni rezultati studija slučajeva i kontrola pokazuju da je prevalencija mutacije FVL signifikantno viša među ženama s neuspješnim IVF-ovima u odnosu na fertilne žene ili žene s uspješnim IVF-om. Isto vrijedi i za žene s pozitivnim antifosfolipidnim protutijelima, što je oblik stečene trombofilije. Međutim, ti rezultati nisu potvrđeni kohortnim studijama koje su ispitivale povezanost neuspjeha IVF-a i trombofilija, a objedinjeni rezultati studija koje su proučavale ostale vrste trombofilija nisu pokazale signifikantnu povezanost ni na razini studija slučajeva i kontrola.
Na koncu, možemo reći da povezanost neuspjeha IVF-a i trombofilija ostaje većinom upitna. Velika prospektivna istraživanja su potrebna kako bi se ova asocijacija razjasnila i kako bi spoznaje s tog područja pomogle u rješavanju problema ponavljanih neuspjeha ostvarenja vlastitog potomstva.

Abstract (english)

Methods of assisted reproductive technologies, such as IVF or ICSI, offer many otherwise infertile couples the opportunity to conceive. However, failure of implantation of the fertilized embryo in the endometrium of the uterus remains a major problem and that is why an average of only 30% of embryo transfers result in live births. The mechanisms responsible for the high failure rate of IVF are largely unexplained and unknown. Recently, an association between failure of IVF and hypercoagulability as a result of thrombophilia was the subject of numerous scientific papers. Thrombophilias can be hereditary and acquired, and the most common thrombophilias are mutations in the genes for proteins involved in the coagulation cascade process such as FVL mutations and prothrombin gene mutation. Hereditary thrombophilia is a relatively common disorder, with the highest prevalence in the Caucasian population that reaches, depending on the study, even more than 15% .
The results of research dealing with this issue are unclear. Combined results from case-control studies showed that FVL mutation was significantly more prevalent among women with IVF failure compared with fertile parous women or those achieving pregnancy after IVF. The same is true for women tested positive for anti-phospholipid antibodies, which is a form of acquired thrombophilia. However, these results have not been confirmed by cohort studies that have examined the connection between IVF failure and thrombophilias. Combined results from studies that have examined other types of thrombophilias did not show a significant association even on the level of case-control studies.
In conclusion, the relationship between IVF failure and thrombophilia remains largely inconclusive. Large prospective studies are needed to clarify these associations in order for knowledge in this field to help in solving the problem of repeated failure in realization of one's own offspring.

• Keywords: trombofilije; IVF; neplodnost; faktor V Leiden; antifosfolipidna protutijela; indukcija ovulacije
• Keywords (english): thrombophilia; IVF; infertility; factor V Leiden; antiphospholipid antibodies; induction of ovulation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:419952
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-03-10 10:17:58