Genetic testing to identify women at risk of venous thromboembolism with contraceptive pills: Evidence or hope-based tool ?

Combined oestrogen-progestin oral contraceptives cause venous thromboembolism in women of reproductive age. Healthcare providers typically rely on women’s characteristics, medical history and family history to select the most appropriate contraceptives, in an effort to reduce risks of venous thromboembolism. This position paper discusses the use of a new prediction tool (Pill Protect®), available in Switzerland, which adds genetic profiling to clinical characteristics with the aim of predicting individual contraceptive-related thrombotic risks and individualising contraceptive prescription. After reviewing the available data regarding this tool, we believe that its development and validation process may be incomplete and that it is uncertain whether the use of Pill Protect® would lead to better health outcomes. Until we understand the necessarily rigorous scientific validation of this tool, we urge caution to physicians and women who may want to use it.