Increased prevalence of thrombophilia among women with severe ovarian hyperstimulation syndrome.
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.
Dulitzky
Mordechai
M
J. Buchmann Gynecology and Maternity Center, The Chaim Sheba Medical Center, Tel Hashomer, Israel. yaronr@post.tau.ac.il
Cohen
Shlomo B
SB
Inbal
Aida
A
Seidman
Daniel S
DS
Soriano
Daniel
D
Lidor
Arieh
A
Mashiach
Shlomo
S
Rabinovici
Jaron
J
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*
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)