A retrospective analysis of fondaparinux versus enoxaparin treatment in women with infertility or pregnancy loss.
OBJECTIVE
We compared the pregnancy success rates and safety parameters of fondaparinux versus enoxaparin, combined with immunotherapy, in patients with a history of miscarriage and/or infertility and coagulant defects.


METHODS
A total of 127 pregnancies in 110 patients with a history of miscarriage and/or infertility were retrospectively evaluated. Of these, 29 pregnancies used fondaparinux 2.5 mg daily and 98 pregnancies used enoxaparin 30 mg twice daily.


RESULTS
The pregnancy success rate was 59% (17/29; 95% CI, 41-75%) for patients receiving fondaparinux and 58% (57/98; 95% CI, 48-68%) for patients receiving enoxaparin. No difference was detected in birth weight (2.7 +/- 0.8 and 2.9 +/- 0.6 kg, respectively) or gestational age at delivery (37.3 +/- 2.2 and 37.7 +/- 2.1 weeks, respectively). No birth defects, severe bleeding-related complications, or serious allergic reactions were observed.


CONCLUSIONS
In patients with a history of miscarriage, infertility, and coagulant defects receiving immunotherapy, fondaparinux resulted in successful pregnancy outcomes comparable with enoxaparin therapy. Although no difference in outcome was observed in our analysis, a much larger study is required to achieve statistical power.
Winger
Edward E
EE
Alan E. Beer Center for Reproductive Immunology & Genetics, San Francisco, CA 94111, USA. ewinger@sbcglobal.net
Reed
Jane L
JL
D000022:Abortion, Spontaneous / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D000328:Adult; D003131:Combined Modality Therapy; D017984:Enoxaparin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D000077425:Fondaparinux; D006801:Humans; D007167:Immunotherapy; D007247:Infertility, Female / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D011134:Polysaccharides / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
D017984:Enoxaparin; D011134:Polysaccharides; D000077425:Fondaparinux