HEREDITARY THROMBOPHILIA AND ASSISTED REPRODUCTION TECHNOLOGY IN INFERTILITY TREATMENT

Trudnoća je stanje u kojem je fiziološki povećana sklonost grušanju krvi, zbog čega je i rizik od venske tromboembolije veći. Trombofilija je urođeno ili stečeno stanje poremećenog mehanizma hemostaze, koji predisponira nastanku tromboze. S obzirom da je trudnoća hiperkoagulabilno stanje, trombofilija je dodatna okolnost koja predisponira nastanku tromboze. Oko 15% svih klinički prepoznatih trudnoća, uz trombofiliju završava spontanim pobačajem, a u 1% parova javljaju se spontani ponavljajući pobačaji. Takvi parovi se zbog neuspjeha reprodukcije često liječe metodama medicinski pomognute oplodnje. Unatoč postupcima MPO, šansa začeća po postupku IVF-om iznosi od 25%-30%. Trombofilija se nerijetko povezuje s lošim ishodima MPO. U ovom istraživanju je retrospektivno analizirana medicinska dokumentacija 200 neplodnih pacijentica koje su bile podijeljene u dvije skupine s obzirom jesu li rodile ili ne. Osim te podjele, bile su podijeljene prema tome imaju li trombofiliju ili ne. Analizirali smo osnovne podatke o pacijenticama, uzroke neplodnosti prema međunarodnoj klasifikaciji bolesti (MKB-10), broj mutacija na genima sustava koagulacije, vrste mutacija i njihove kombinacije na genima sustava koagulacije, broj prirodno začetih trudnoća i broj spontanih pobačaja. Pacijentice sa trombofilijom imaju veće poteškoće u liječenju neplodnosti od onih koje nemaju trombofiliju. Ukoliko trombofilija nije dijagnosticirana, liječenje neplodnosti postupcima MPO, češće neće biti uspješno.Pregnancy is a condition in which a physiologically increased risk of blood coagulation is associated with higher risk of venous thromboembolism. Thrombophilia is an inherited or acquired condition of a disrupted hemostasis mechanism that predisposes the formation of thrombosis. Since pregnancy is a hypercoagulable condition, thrombophilia is an additional circumstance that predisposes the occurrence of thrombosis. Approximately 15% of all clinically recognized pregnancies end with spontaneous abortion, and in 1% pairs spontaneous recurring abortions occur. Due to the failure of reproduction, such couples often choose to be treated with the methods of assisted reproduction. Despite the procedures, IVF conception rate is 25%-30%. Thrombophilia is often associated with poor outcomes of the methods of assisted reproduction. In this study, 200 infertile patients were retrospectively analyzed. Patients were divided into two groups considering whether they gave birth or not. Another important parameter was presence or absence of thrombophilia. We analyzed patient`s basic data, cases of infertility according to international classification of diseases, the number of mutations, types and combination of mutations on the coagulation and pregnancy system genes, number of naturally conceived pregnancies and number of spontaneous abortions. Patients with thrombophilia had bigger problems in infertility treatments than patients without thrombophilia. In cases when thrombophilia is not diagnosed, positive outcomes of infertility treatments with the methods of assisted reproduction are lower