An enhanced clot growth rate before in vitro fertilization decreases the probability of pregnancy.

BACKGROUND: The shift towards hypercoagulation during in vitro fertilization (IVF) can lead to the impairment of embryo implantation and placental blood circulation, which is believed to be a factor in an unsuccessful IVF cycle. OBJECTIVES: To assess coagulation in women with infertility before the start of an IVF cycle and during treatment to reveal the association between coagulation imbalance and IVF outcome. PATIENTS/METHODS: We conducted a prospective cohort observational study including 125 participants who underwent fresh IVF cycles. Blood samples were collected at five time points: before IVF, one week after the start of controlled ovarian stimulation (COS), on the day of follicular puncture, on the day of embryo transfer (ET) and one week after ET. Coagulation tests (clotting times: activated partial thromboplastin time (APTT) and prothrombin; fibrinogen and D-dimer concentrations; thrombodynamics) were performed. RESULTS: Women with an elevated clot growth velocity (>32.3 µm/min, detected by thrombodynamics) before IVF demonstrated a higher risk of negative IVF outcomes (adjusted RR = 1.38; 95% CI 1.28-1.49; P<0.001). During the procedure, we observed increases in prothrombin, fibrinogen and D-dimer concentrations, a slight shortening of APTT and a hypercoagulation shift in the thrombodynamics parameters. The hemostasis assay values during COS and after ET had no associations with IVF outcomes. CONCLUSIONS: Hypercoagulation in the thrombodynamics before the start of IVF treatment was associated with negative IVF outcomes. After the start of COS, all tests demonstrated a hypercoagulation trend, but the hypercoagulation did not influence IVF outcome. This research is potentially beneficial for the application of thrombodynamics assay for monitoring hemostasis in infertile women prior to an IVF procedure with the goal of selecting a group requiring hemostasis correction to increase the chances of pregnancy.

[Detection of viral-bacterial factors responsible for infertility in couples]. / Vyiavlenie spektra virusno-bakterial'nykh faktorov, indutsiruiushchikh besplodie u supruzheskikh par.

A high prevalence of genital infections was revealed in patients suffering for a long time from sterility. The inflammatory process was found to predominate in tubal sterility. In other forms of sterility with asymptomatic urogenital infections the couples are frequently unaware of the disease and are not properly examined. Genital inflammations not diagnosed for many years augment the endocrine disorders and stimulate the development of autoimmune states. Today, a mixed viral/bacterial urogenital infection is the principal cause of reproductive disorders.