title: Increased prevalence of thrombophilia among women with severe ovarian hyperstimulation syndrome.
abstract: OBJECTIVE
  To determine the prevalence of markers of thrombophilia in women hospitalized for severe OHSS.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Academic research center.
  
  
  METHODS
  Women undergoing induction of ovulation complicated by severe OHSS (n = 20) and women undergoing induction of ovulation without development of severe OHSS (n = 41).
  
  
  METHODS
  Blood samples to test for markers of thrombophilia were obtained during the luteal phase of the treatment cycle.
  
  
  METHODS
  Blood samples were analyzed for markers of thrombophilia, such as plasma levels of antithrombin, protein S and protein C, antiphospholipid antibodies, the factor V Leiden mutation, and 677T polymorphism in the 5,10 methyltetrahydrofolate reductase (MTHFR 677T) gene.
  
  
  RESULTS
  Seventeen of 20 patients with severe OHSS (85%) and 11 of 41 controls (26.8%) had one or more positive markers of thrombophilia. Of the women with severe OHSS, 6 had a decreased antithrombin level, 8 had decreased levels of protein S, 7 were homozygous for the MTHFR 677T mutation, 1 was heterozygous for the factor V Leiden mutation, and 5 had antiphospholipid antibodies. Eight women with OHSS and no controls had more than one positive marker of thrombophilia.
  
  
  CONCLUSIONS
  The prevalence of thrombophilia is increased in women with severe OHSS. These findings suggest that prophylactic screening for this disorder and possible use of heparin prophylaxis for thromboembolic phenomena should be considered in these patients.
authors.affiliation: J. Buchmann Gynecology and Maternity Center, The Chaim Sheba Medical Center, Tel Hashomer, Israel. yaronr@post.tau.ac.il
authors.forename: Mordechai
authors.initials: M
authors.lastname: Dulitzky
authors.forename: Shlomo B
authors.initials: SB
authors.lastname: Cohen
authors.forename: Aida
authors.initials: A
authors.lastname: Inbal
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Seidman
authors.forename: Daniel
authors.initials: D
authors.lastname: Soriano
authors.forename: Arieh
authors.initials: A
authors.lastname: Lidor
authors.forename: Shlomo
authors.initials: S
authors.lastname: Mashiach
authors.forename: Jaron
authors.initials: J
authors.lastname: Rabinovici
mesh_terms: D017152:Antibodies, Antiphospholipid / Q000097:blood; D000990:Antithrombin III; D004247:DNA / Q000235:genetics; D005165:Factor V / Q000235:genetics / Q000378:metabolism; D005260:Female; D006801:Humans; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood / Q000150:complications*; D010062:Ovulation Induction / Q000009:adverse effects*; D000587:Oxidoreductases Acting on CH-NH Group Donors / Q000235:genetics / Q000378:metabolism; D010446:Peptide Fragments / Q000097:blood; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D011486:Protein C / Q000378:metabolism; D017293:Protein S / Q000378:metabolism; D019851:Thrombophilia / Q000097:blood / Q000150:complications*
chemical_list: D017152:Antibodies, Antiphospholipid; D010446:Peptide Fragments; D011486:Protein C; D017293:Protein S; C101078:antithrombin (342-347); C095381:factor V Leiden; D000990:Antithrombin III; D005165:Factor V; D004247:DNA; D000587:Oxidoreductases Acting on CH-NH Group Donors; D042965:Methylenetetrahydrofolate Reductase (NADPH2)