Infertility and Inherited Thrombophilia

Infertility is a condition that affects between one-fifth and one-sixth of couples of reproductive age. It is defined as a reduction in or a lack of ability to reproduce and its cause may lie either in the male or female partner (Stedman, 2006). According to the American Society for Reproductive Medicine, infertility should be considered when pregnancy fails to occur after one year of regular sexual activity without the use of any contraceptive method. In view of its high incidence, infertility currently constitutes a significant health issue. The social structure prevalent today in which women are conditioned to consider motherhood at a later age results in an increase in the number of couples seeking medical assistance to fulfill their dream of having children (Neuspiller, 2003). Nevertheless, the forms of treatment available today within the realm of assisted reproduction result in a pregnancy rate of approximately 40%, an unsatisfactory percentage, since it means that the majority of couples are still denied the opportunity to conceive (Qublan, 2006; Vaquero et al., 2006). In 30% of the couples currently undergoing treatment for infertility, the factors preventing them from becoming pregnant have yet to be identified (Grandone, 2005). The majority of the studies conducted to evaluate failure to conceive in assisted reproduction have focused on the problems that occur following laboratory fertilization, i.e. implantation of the embryo in the woman’s uterus (Vaquero et al., 2006). Various studies have concentrated on improving factors associated with the embryo, such as the quality and quantity of embryos, and on female factors. Some that need to be taken into consideration include improving endometrial receptivity and identifying intervening factors associated with immunological response and the genetic characteristics of the woman, including her potential for coagulation during pregnancy and implantation of the embryo (Glueck, 2000). Because of the success rate of 34%, the assisted reproduction clinics try to improve the pregnancy rate by transferring more than one embryo. This procedure has as a consequence, another problem of great significance and social impact, which is the multiple pregnancy (Haggarty, 2006). Recently, a hypothesis has been raised that the same factors associated with the occurrence of recurrent pregnancy loss may also affect the early phase of the embryo implantation process (Vaquero et al., 2006). The possible causes for a failure in embryo implantation have been widely investigated; however, there is no consensus in the literature on this subject.