Efficacy of Low-molecular-weight Heparin on the Outcomes of in Vitro Fertilization/intracytoplasmic Sperm Injection Pregnancy in Non-thrombophilic Women: a Meta-analysis

Overview

Journal Acta Obstet Gynecol Scand

Publisher Wiley

Specialty Gynecology & Obstetrics

Date 2018 Apr 28

PMID 29700821

Citations 10

Authors

Xiu-Li Yang

Fei Chen

Xiu-Ying Yang

Guan-Hua Du

Yang Xu

Affiliations

Soon will be listed here.

Abstract

Introduction: The aim of our study was to evaluate the effect of low-molecular-weight heparin on pregnancy outcomes in women without thrombophilia during in vitro fertilization/intracytoplasmic sperm injection treatment.

Material And Methods: We searched Pubmed, Web of Science, Embase, Cochrane and CNKI (from inception to 2 February 2018). Our study identified randomized controlled trials or quasi-randomized controlled trials comparing low-molecular-weight heparin subcutaneous treatment with no treatment or only luteal support control. The outcomes included live birth rate, clinical pregnancy rate and miscarriage rate.

Results: Five trials, including 935 women receiving in vitro fertilization/intracytoplasmic sperm injection treatment, were included in meta-analyses. There were 458 women receiving low-molecular-weight heparin and 477 in the control group. No significant differences for live birth rate, clinical pregnancy rate and miscarriage rate were found between the low-molecular-weight heparin and control groups. Of them, four trials reported live birth rate as an outcome and the risk ratio was 1.13 (95% confidence interval 0.88-1.43, p = 0.34). All five trials reported clinical pregnancy rate as an outcome, the risk ratio was 1.08 (95% confidence interval 0.87-1.32, p = 0.47). Three trials reported miscarriage rate and the risk ratio was 0.58 (95% confidence interval 0.30-1.10, p = 0.09). In women with two or more failed in vitro fertilization/intracytoplasmic sperm injection cycles, the risk ratio of live birth rate was 1.15 and the risk ratio of clinical pregnancy rate was 1.17. In women with three or more failed in vitro fertilization/intracytoplasmic sperm injection cycles, the risk ratios of live birth rate and clinical pregnancy rate were 1.36 and 1.35, respectively.

Conclusions: Our results suggested that low-molecular-weight heparin had no effect on pregnancy success rate in non-thrombophilic women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment. However, to justify the use of low-molecular-weight heparin in clinical practice, multicenter trials are still necessary.

Citing Articles

A disproportionality analysis of low molecular weight heparin in the overall population and in pregnancy women using the FDA adverse event reporting system (FAERS) database.

Xu H, Xu N, Wang Y, Zou H, Wu S Front Pharmacol. 2024; 15:1442002.

PMID: 39188956 PMC: 11345143. DOI: 10.3389/fphar.2024.1442002.

Low-molecular-weight heparin and preeclampsia - does the sword cut both ways? Three case reports and review of literature.

Shan D, Li T, Tan X, Hu Y World J Clin Cases. 2024; 12(9):1634-1643.

PMID: 38576748 PMC: 10989419. DOI: 10.12998/wjcc.v12.i9.1634.

[Anti-endothelial cell antibodies in predicting early miscarriage].

Luo L, Li Y, Wang H, Xiang X, Zhao J, Sun F Beijing Da Xue Xue Bao Yi Xue Ban. 2023; 55(6):1039-1044.

PMID: 38101786 PMC: 10723987.

Delphi consensus on add-ons and social midia in Assisted Reproductive Technology.

Ceschin A, Petracco A, Borges Jr E, Cordts E, Nakagawa H, Souza M JBRA Assist Reprod. 2023; .

PMID: 37850861 PMC: 10718546. DOI: 10.5935/1518-0557.20230047.

Low-molecular-weight heparin in thrombophilic women receiving in vitro fertilization/intracytoplasmic sperm injection: A meta-analysis.

Chen J, Bie J, Jiang F, Wu Y, Pan Z, Meng Y Acta Obstet Gynecol Scand. 2023; 102(11):1431-1439.

PMID: 37475190 PMC: 10577622. DOI: 10.1111/aogs.14634.

References

Potdar N, Gelbaya T, Konje J, Nardo L . Adjunct low-molecular-weight heparin to improve live birth rate after recurrent implantation failure: a systematic review and meta-analysis. Hum Reprod Update. 2013; 19(6):674-84. DOI: 10.1093/humupd/dmt032. View

Jadad A, Moore R, Carroll D, Jenkinson C, Reynolds D, Gavaghan D . Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials. 1996; 17(1):1-12. DOI: 10.1016/0197-2456(95)00134-4. View

Rodger M, Hague W, Kingdom J, Kahn S, Karovitch A, Sermer M . Antepartum dalteparin versus no antepartum dalteparin for the prevention of pregnancy complications in pregnant women with thrombophilia (TIPPS): a multinational open-label randomised trial. Lancet. 2014; 384(9955):1673-83. DOI: 10.1016/S0140-6736(14)60793-5. View

Siristatidis C, Chrelias C, Creatsa M, Varounis C, Vrachnis N, Iliodromiti Z . Addition of prednisolone and heparin in patients with failed IVF/ICSI cycles: a preliminary report of a clinical trial. Hum Fertil (Camb). 2013; 16(3):207-10. DOI: 10.3109/14647273.2013.803608. View

Grandone E, Villani M, Tiscia G, Dentali F, Colaizzo D, Cappucci F . Clinical Pregnancies and Live Births in women approaching ART: a follow-up analysis of 157 women after thrombophilia screening. Thromb Res. 2013; 133(2):168-72. DOI: 10.1016/j.thromres.2013.11.016. View

Hamdi K, Danaii S, Farzadi L, Abdollahi S, Chalabizadeh A, Abdollahi Sabet S . The Role of Heparin in Embryo Implantation in Women with Recurrent Implantation Failure in the Cycles of Assisted Reproductive Techniques (Without History of Thrombophilia). J Family Reprod Health. 2015; 9(2):59-64. PMC: 4500816. View

Yang X, Chen F, Yang X, Du G, Xu Y . Efficacy of low-molecular-weight heparin on the outcomes of in vitro fertilization/intracytoplasmic sperm injection pregnancy in non-thrombophilic women: a meta-analysis. Acta Obstet Gynecol Scand. 2018; 97(9):1061-1072. PMC: 6100106. DOI: 10.1111/aogs.13359. View

Nelson S, Greer I . The potential role of heparin in assisted conception. Hum Reprod Update. 2008; 14(6):623-45. DOI: 10.1093/humupd/dmn031. View

Dentali F, Ageno W, Rezoagli E, Rancan E, Squizzato A, Middeldorp S . Low-dose aspirin for in vitro fertilization or intracytoplasmic sperm injection: a systematic review and a meta-analysis of the literature. J Thromb Haemost. 2012; 10(10):2075-85. DOI: 10.1111/j.1538-7836.2012.04886.x. View

10.

Mantel N, Haenszel W . Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959; 22(4):719-48. View

11.

Folkeringa N, Brouwer J, Korteweg F, Veeger N, Erwich J, Holm J . Reduction of high fetal loss rate by anticoagulant treatment during pregnancy in antithrombin, protein C or protein S deficient women. Br J Haematol. 2007; 136(4):656-61. DOI: 10.1111/j.1365-2141.2006.06480.x. View

12.

Fishel S, Baker D, Elson J, Ragunath M, Atkinson G, Shaker A . Precision Medicine in Assisted Conception: A Multicenter Observational Treatment Cohort Study of the Annexin A5 M2 Haplotype as a Biomarker for Antithrombotic Treatment to Improve Pregnancy Outcome. EBioMedicine. 2016; 10:298-304. PMC: 5006578. DOI: 10.1016/j.ebiom.2016.06.024. View

13.

Siristatidis C, Dafopoulos K, El-Khayat W, Salamalekis G, Anifandis G, Vrantza T . Administration of prednisolone and low molecular weight heparin in patients with repeated implantation failures: a cohort study. Gynecol Endocrinol. 2017; 34(2):136-139. DOI: 10.1080/09513590.2017.1380182. View

14.

Seshadri S, Sunkara S, Khalaf Y, El-Toukhy T, Hamoda H . Effect of heparin on the outcome of IVF treatment: a systematic review and meta-analysis. Reprod Biomed Online. 2012; 25(6):572-84. DOI: 10.1016/j.rbmo.2012.08.007. View

15.

Rodger M, Gris J, de Vries J, Martinelli I, Rey E, Schleussner E . Low-molecular-weight heparin and recurrent placenta-mediated pregnancy complications: a meta-analysis of individual patient data from randomised controlled trials. Lancet. 2016; 388(10060):2629-2641. DOI: 10.1016/S0140-6736(16)31139-4. View

16.

Shirlow R, Healey M, Volovsky M, MacLachlan V, Vollenhoven B . The Effects of Adjuvant Therapies on Embryo Transfer Success. J Reprod Infertil. 2017; 18(4):368-378. PMC: 5691253. View

17.

Noci I, Milanini M, Ruggiero M, Papini F, Fuzzi B, Artini P . Effect of dalteparin sodium administration on IVF outcome in non-thrombophilic young women: a pilot study. Reprod Biomed Online. 2011; 22(6):615-20. DOI: 10.1016/j.rbmo.2011.03.016. View

18.

Tong M, Jiang H, Liu P, Lawson J, Brass L, Song W . Spontaneous fetal loss caused by placental thrombosis in estrogen sulfotransferase-deficient mice. Nat Med. 2005; 11(2):153-9. DOI: 10.1038/nm1184. View

19.

Baglin T, Gray E, Greaves M, Hunt B, Keeling D, Machin S . Clinical guidelines for testing for heritable thrombophilia. Br J Haematol. 2010; 149(2):209-20. DOI: 10.1111/j.1365-2141.2009.08022.x. View

20.

Akhtar M, Sur S, Raine-Fenning N, Jayaprakasan K, Thornton J, Quenby S . Heparin for assisted reproduction. Cochrane Database Syst Rev. 2013; (8):CD009452. PMC: 10788127. DOI: 10.1002/14651858.CD009452.pub2. View