The Role of Heparin in Embryo Implantation in Women with Recurrent Implantation Failure in the Cycles of Assisted Reproductive Techniques (Without History of Thrombophilia)
Abstract
Objective:Several studies have shown the improving effect of heparin on the outcomes of ART. Moreover, it has been reported that adding heparin in non-thrombophilia patients with RIF is useful.The aim of this study was to evaluate the beneficial effects of heparin on ART outcomes in women with history of recurrent implantation failure (RIF) and without history of congenital or acquired thrombophilia in a randomized, controlled clinical trial (RCT).
Materials and methods:In this study, 100 patients with a history of two or more failures in implantation in cycles of ART were randomly subdivided into two groups of study and control. Patients of the control group just received the luteal phase support. In the patients of study group, in addition to the routine support of luteal phase following in vitro fertilization (IVF) or intra cytoplasmic sperm injection (ICSI), 5000 units of subcutaneous heparin was administered for 15 days from the day of oocyte pick up. Pregnancy test (β-HCG) was done for patient of two groups 15 days after IVF.In the study group, pregnancy test was positive in 16 (32%) patients and negative in 34 (68%) patients.
Results:In the control group, pregnancy test was positive in 15 (30%) patients and negative in 35 (70%) patients. There was no significant difference between two groups for the role of heparin in the pregnancy rate (p = 0.5).Although the effect of heparin on pregnancy was not statistically significant in this study, with regard to the numerous benefits of this agent, it is recommended to study its effects in further studies with lager sample size.
Textbook of in vitro fertilization and assisted reproduction: the Bourn Hall guide to clinical and laboratory practice/ edited by Peter R. Brinsden. Edition: 3rd ed. London: Taylor & Francis, 2005: 221-2.
Hossain N, Schatz F, Paidas MJ. Heparin and maternal fetal interface: why should it work to prevent pregnancy complications? Thrombosis research 2009; 124: 653-5.
Gardner DK, Weissman A, Howles CM, Shoham Z. Textbook of Assisted Reproductive Technology and Clinical Perspectives. London: Taylor & Francis, 2012; 2: 208-20.
Fiedler K, Wurfel W. Effectivity of Heparin in Assisted Reproduction. European Journal of Medical Research 2004; 9: 207-14.
Fritz MA, Speroff L. Clinical Gynecologic Endocrinology and Infertility, 8th ed. Philadelphia: Lippincott Williams & Wilkins; 2011; 261-5.
Bohlmann MK. Effects and effectiveness of heparin in assisted reproduction. Journal of Reproductive Immunology 2011; 90: 82-90.
Urman B, Ata B, Yakin K, Alatas C, Aksoy S, Mercan R, et al. Luteal phase empirical low molecular weight heparin administration in patients with failed ICSI embryo transfer ycles: a randomized open-labeled pilot trial. Hum Reprod 2009; 24: 1640-7.
Akhtar MA, Eljabu H, Hopkisson J, Raine-FenningN, Quenby S, Jayaprakasan K. Aspirin and heparin as adjuvants during IVF do not improve live birth rates in unexplained implantation failure. Reproductive Bio Medicine Online 2013; 26: 586-94.
Noci I, Milanini MN, Ruggiero M, Papini F, Fuzzi B, Artini PG. Effect of dalteparin sodium administration on IVF outcome in non-thrombophilic young women: a pilot study. Reprod Biomed Online 2011; 22: 615-20.
Stern C, Chamley L, Norris H, Hale L, Baker HWG. A randomized, double-blind, placebo-controlled trial of heparin and aspirin for women with in vitro fertilization implantation failure and antiphospholipid or antinuclear antibodies. Fertility and Sterility 2003; 80: 376-383.
Sher G, Feinman M, Zouves C, Kuttner G, Maassarani G, Salem R, et al. High fecundity rates following in-vitro fertilization and embryo transfer in antiphospholipid antibody seropositive women treated with heparin and aspirin. Hum Reprod 1994; 9: 2278-83.
Simon A, Laufer N. Assessment and treatment of repeated implantation failure (RIF). J Assist Reprod Genet 2012; 29: 1227-39.
Sher G, Maassarani G, Zouves C, Feinman M, Sohn S, Matzner W, et al. The use of combined heparin/aspirin and immunoglobulin G therapy in the treatment of in vitro fertilization patients with antithyroid antibodies. Am J Reprod Immunol 1998; 39: 223-5.
Files | ||
Issue | Vol 9, No 2 (June 2015) | |
Section | Original Articles | |
Keywords | ||
ART Heparin Pregnancy test Recurrent implantation failure |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |