ABSTRACT

Summary: Prevalence of iherited thrombophilia in patients with severe ovarian hyperstimulation syndrome.

Objective: to determine the prevalence of markers of inherited thrombophilia in patients with severe form of ovarian hypesrtimulation syndrome (OHSS).

Design: Cohort study.

Material and methods: blood samples were analysed for markers of thrombophilias (mutation of factor V – Leiden, mutation of methylentetrahydropholat reductase (MTHFR) C677T, mutation of prothrombin G20210A and antithrombin, protein C, protein S deficiencies). Study group consist of women who underwent controlled ovarian hyperstimulation for IVF complicated by severe OHSS (group A, n = 50). Results were compared with two controls groups – women who underwent ovarian hyperstimulation for IVF without developing OHSS (group B, n = 93) and healthy pregnant women with no history of infertility (group C, n = 196).

Results: we found 7 out of 50 patients from group A positive for Leiden mutation (heterozygots) in comparison with 11 out of 93 from group B (heterozygots), p = 0,71 OR 1,21 (0,39 – 3,70) and 10 out of 196 from group C (heterozygots), p = 0,03 OR 3,03 (0,97–9,28). The polymorphism of MTHFR 677T gene was detected in 17 out of 50 patients (heterozygots) from group A, in 36 out of 93 patients from group B (35 heterzygots, 1 homozygot) and in 93out of 196 patients from group C (86 heterozygots, 7 homozygots) with no statistical significance. One patient from group A and one patient from group B had protein S deficiency, we did not find any protein C or antithrombin deficiencies.

Conclusion: we found increased prevalence of factor V Leiden mutation in Czech infertile women. Carriers of Leiden mutation had no ehanced risk of development severe form of OHSS during stimulation.

Key words: ovarian hyperstimulation syndrome, thrombophilia, factor V Leiden mutation