Venous thromboembolism in relation to in vitro fertilization: an approach to determining the incidence and increase in risk in successful cycles

The incidence of first-trimester venous thromboembolism in IVF pregnancies was 0.2%, which was mainly attributed to a 100-fold increased risk in cycles complicated by ovarian hyperstimulation syndrome.

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Authors

Karin Rova, M.D., Henrik Passmark, M.Sc., Pelle G. Lindqvist, M.D., Ph.D.

Vol 97, Issue 1 , Pages 95-100

Abstract

Objective:

To determine the incidence and the increase in risk of venous thromboembolism (VTE) in relation to IVF and ovarian hyperstimulation syndrome (OHSS) in successful cycles.

Design:

Cohort study.

Setting:

Population based.

Patient(s):

All deliveries (n = 964,532) in Sweden during a 10-year period (1999–2008).

Intervention(s):

Comparison of VTEs among those with and without IVF. The National Birth Registry was cross-matched with both the National Discharge Registry and the National IVF Registry. Logistic regression analysis was used to determine odds ratios and 95% confidence intervals.

Main Outcome Measure(s):

Risk of first trimester VTE.

Result(s):

The incidence of first-trimester VTE in relation to IVF was 0.2%, representing a 10-fold increase as compared with the background population. The 6% to 7% of IVF pregnancies that were complicated by OHSS showed a 100-fold increased risk of VTE, as opposed to the fivefold increased risk seen in the absence of OHSS. The VTEs in conjunction with IVF were diagnosed at a mean gestational age of 62 days; there was no increased risk of VTE related to frozen embryo replacement cycles or IVF after the first trimester.

Conclusion(s):

Treating women with OHSS with low-molecular-weight heparin thromboprophylaxis during the first trimester and treating cases at high-risk for OHSS with frozen embryo replacement is likely to lower the risk of VTE.

Read the full text at: http://www.fertstert.org/article/S0015-0282(11)02723-3/fulltext

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.