PB1535 - Dynamics of hemostasis in women undergoing in vitro fertilization

Tuesday, June 27, 2023

18:30 – 19:30 ET

Room: Exhibition

Co-Author(s)

Lucia Stančiaková, MD, PhD. (she/her/hers)

physician-researcher
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia

Co-Author(s)

Kristína Vajdová, MD, PhD.

laboratory researcher
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
MD

Miroslava Dobrotová

physician-hematologist
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
PH

Pavol Holly

physician-hematologist
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
Ingrid Skornova, Ing.

Laboratory diagnostician
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
JI

Jela Ivanková

laboratory researcher
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
Jana Zolkova, DSc, PhD (she/her/hers)

laboratory researcher
National Centre of Hemostasis and Thrombosis, Department of Hematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Slovakia
Martin, Zilina, Slovakia
�V

Ľubica Vadelová

laboratory researcher
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia 2Center of Hemostasis and Thrombosis - Unilabs Slovakia, s. r. o., Martin, Slovakia
Martin, Zilina, Slovakia
TB

Tomáš Bolek

physician-internist
Department of Internal Medicine I, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
MS

Matej Samoš

university professor
Department of Internal Medicine I, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
JD

Ján Danko

university professor
Department of Gynecology and Obstetrics, Comenius University In Bratislava, Jessenius Faculty of Medicine in Martin, University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
KB

Kamil Biringer

associate professor, gynecologist
Department of Gynecology and Obstetrics, Comenius University In Bratislava, Jessenius Faculty of Medicine in Martin, University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia
PK

Peter Kubisz

university professor
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia

Presenting Author(s)

Jan Stasko, MD, PhD (he/him/his)

university professor
National Center of Hemostasis and Thrombosis, Department of Hematology and Transfusion Medicine, Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin and University Hospital in Martin, Martin, Slovakia
Martin, Zilina, Slovakia

Background: In vitro fertilization (IVF) is one of the most effective procedures used in the treatment on infertility. Tendency for hypercoagulation during IVF might lead to the impairment of embryo implantation and placental blood circulation that is presumed to be a risk factor for an unsuccessful IVF cycle.

Aims: The authors present the results of their experience with the detection of changes in hemostasis in patients after IVF.

Methods: In this study, we included 19 patients with previous pregnancy loss, who were therefore pregnant after IVF. We evaluated hemostatic parameters (D-dimers, factor VIII activity, PS function, ProC Global ratio, anti-Xa activity for low molecular weight heparin (LMWH) and platelet count) in the 10th-12th (time interval 1 (T1)), 16th-18th (T2), 26th-28th (T3), 35th-36th week of gestation (T4) and 6-8 weeks following delivery (T5).

Results: Despite the adequate anticoagulant thromboprophylaxis with the use of LMWH, our results point out to the progression of hypercoagulation during pregnancy (increase in levels of D-dimers and factor VIII activity, decrease of free protein S function and ProC Global ratio). These parameters started to normalize in T5.
The change in the dose of LMWH was suggested mainly in T4.

Moreover, we observed the absence of the normalization of some parameters even after the postpartum period (Table 1).

Conclusion(s): Assessment of changes in hemostasis in the pregnant women undergoing IVF methods and using LMWH during the pregnancy and postpartum period might be useful for the individual evaluation of the termination of such anticoagulant thromboprophylaxis.

The study complies with the Declaration of Helsinki and from each patient, the informed consent was obtained. The study was approved by a recognized medical Ethics Committee.
Acknowledgement: We would like to thank the support of projects of Scientific Grant Agency Vega 1/0168/16, Vega 1/0549/19 and Vega 1/0479/21.