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Semin Reprod Med 2021; 39(05/06): 180-185
DOI: 10.1055/s-0041-1732375
Review Article

Prior Thromboembolic Disease and Assisted Reproductive Therapy

Anne Flem Jacobsen
1   Institute of Clinical Medicine, University of Oslo, Oslo, Norway
2   Department of Obstetrics, Oslo University Hospital, Oslo, Norway
,
Per Morten Sandset 
1   Institute of Clinical Medicine, University of Oslo, Oslo, Norway
3   Department of Hematology, Oslo University Hospital, Oslo, Norway
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Abstract

Assisted reproductive therapy (ART) increases the risk of venous thrombosis (VT) by 2- to 4-fold, whereas pregnancy increases the risk by 5- to 10-fold. Women with a history of VT undergoing ART are often suggested thromboprophylaxis. The literature is scarce and international guidelines are lacking. We made a review of the literature and base our suggestions primarily on expert opinions. We suggest women with a prior VT to use low-molecular-weight heparin as thromboprophylaxis starting from ovarian stimulation, throughout pregnancy, and 6 weeks postpartum. Assessment of VT risk should be done prior to ART. Adjustment of treatment to minimize the thrombotic risk, such as preventing ovarian hyperstimulation syndrome, single-embryo transfer, cryopreservation, and transfer of frozen embryos instead of fresh embryo in high-risk women, is suggested. Women with previous arterial thrombosis should continue aspirin during ART treatment, pregnancy, and postpartum.

Keywords

venous thrombosis - arterial thrombosis - assisted reproductive therapy - in vitro fertilization - previous thromboembolic disease


Publication History

Article published online:
14 July 2021

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