Recurrent IVF/ICSI-ET failure and its relationship with thrombophilia

Abstract

Context: The role of the hereditary thrombophilia in recurrent implantation failure is not clear. There is a conflicting data in the literature. Objectives: This study investigates the relationship between hereditary thrombophilia and recurrent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI)-embryo transfer (ET) implantation failure. Patient(s): The study group included 100 consecutive women with at least three previously failed IVF/ICSI-ET cycles (Group A). Group B included 50 women with a live birth in her first IVF/ICSI-ET cycle. Group C consisted of 50 women who conceived spontaneously with at least one uneventful pregnancy and delivery. Intervention(s): Peripheral blood was collected in Na2 EDTA vacuum tubes from the patients. The genotype of the three mutations – FVL mutation, prothrombin mutation, and MTHFR C677T and A1298C mutations – was detected by genomic DNA isolation using the spin colon DNA isolation method. Main outcome(s): All women were tested for the presence of factor V Leiden (FVL), prothrombin gene, and methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C mutations. Results: A similar prevalence of FVL, prothrombin, and MTHFR mutations was found in all groups. At least one inherited thrombophilic factor was detected in 95% of women with repeated IVF/ICSI failure (group A) and in 84% and 94% of women in groups B and C, respectively. Combined thrombophilia (two or more thrombophilic factors) was 40%, 26%, and 30% for groups A, B, and C, respectively. No statistical association was found between repeated IVF/ICSI failure and these thrombophilic factors. Conclusions: Our results suggest that FVL, MTHFR, and prothrombin gene mutation do not have a significant role in IVF/ICSI-ET implantation failure.