Clinical Utility of Antithrombotic Prophylaxis in ART Procedures: An Italian Experience

BACKGROUND The usefulness of antithrombotic prophylaxis in management of Assisted Reproductive Technologies (ART) is questionable. OBJECTIVES We prospectively examined the contribution of an antithrombotic prophylaxis in influencing clinical pregnancy and live-birth in an unselected cohort of women approaching ART. PATIENTS/METHODS 1107 women with fertility problems and a valid indication for ART were recruited. Baseline and follow-up information of obstetric outcomes and antithrombotic treatment were collected. RESULTS AND CONCLUSIONS Median follow-up time was 34.5 months (range: 2-143). During the follow-up period, 595 (53.8%) women underwent ART (total 1234 cycles); 202 (33.9%) women achieved a pregnancy for a total of 255 clinical pregnancies. The concomitant use of LMWH and aspirin was significantly associated with a higher rate of clinical pregnancies (p: 0.003, OR: 4.9, 95% CI: 1.7-14.2). The pregnancy rate was also significantly increased by the use of LMWH alone (p: 0.005, OR: 2.6, 95% CI: 1.3-5.0). Carriership of inherited or acquired thrombophilia did not affect clinical outcomes of the ART. The efficacy of antithrombotic treatment was confirmed when the outcome " live-birth" was considered. Present data suggest a potential benefit of antithrombotic prophylaxis during ART in improving the number of live-births.