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45 - Thrombophilia and Implanation Failure

from PART III - ASSISTED REPRODUCTION

Published online by Cambridge University Press:  04 August 2010

By
Sameh Mikhail ,
Botros R. M. B. Rizk ,
Mary George Nawar  and
Christopher B. Rizk
Edited by
Botros R. M. B. Rizk ,
Juan A. Garcia-Velasco ,
Hassan N. Sallam  and
Antonis Makrigiannakis
Botros R. M. B. Rizk
Affiliation:
University of South Alabama
Juan A. Garcia-Velasco
Affiliation:
Rey Juan Carlos University School of Medicine,
Hassan N. Sallam
Affiliation:
University of Alexandria School of Medicine
Antonis Makrigiannakis
Affiliation:
University of Crete
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Summary

INTRODUCTION

Human reproduction is an inefficient process. It is estimated that approximately one-fifth of conceptions result in life birth (1, 2). During the past three decades, substantial progress has been achieved in improving stimulation protocols and fertilization procedures. In the same period, however, there was only minimal advancement embryo implantation and pregnancy rate per embryo transfer (3). The average birthrate per complete cycle of in vitro fertilization (IVF) still ranges from 29.9 to 43.7 percent per egg retrieval (4).

It has been estimated that 30 percent of embryos are lost in the preimplantation phase, and 30 percent are lost after the embryo is implanted in the uterus (5). It has been suggested that unsuccessful implantation is attributed to abnormal embryo karyotype (6). Data from genetic studies, however, indicate that the overall prevalence of karyotype abnormalities among preimplantation embryos ranges from 50 to 60 percent (7, 8). Based on these data, the expected implantation rate would be much higher than currently observed (9). This discrepancy suggests that implantation failure could be the result of abnormalities in the mother (6).

Recent evidence suggest that abnormalities such as thyroid anomalies, increased levels of circulating natural killer cells (10, 12), the presence of mouse embryo assay factor (13, 14), and inherited and acquired thrombophilia may contribute to the failure of implantation (15).

Keywords

acquired thrombophiliaantiphospholipid antibody syndromeaspirincorticosteroidsimplantation failureinherited thrombophiliaintravenous immunoglobulinheparin
Type
Chapter
Information
Infertility and Assisted Reproduction , pp. 407 - 415
Publisher: Cambridge University Press
Print publication year: 2008

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