title: Fibrinolysis alterations in infertile women during controlled ovarian stimulation: influence of BMI and genetic components.
abstract: BACKGROUND
  Ovarian stimulation protocols have been described to induce prothrombotic phenotype through alterations of both coagulation and fibrinolysis pathways. We investigated fibrinolytic changes during ovarian stimulation through a global test (CLT) and PAI-1 and TAFI concentrations at different times of ovarian stimulation procedure, and the influence of polymorphisms in genes encoding for fibrinogen chains (FGA, FGB, FGG), t-PA (PLAT), TAFI (CBP2), FXIII (FXIIA1, FXIIIB), plasminogen (PLG) and PAI-1 (PAI1) on their intermediate phenotype.
  
  
  METHODS
  We evaluated fibrinolytic and genetic parameters in 110 infertile women undergoing ovarian stimulation procedure (in vitro fertilization, IVF or intracytoplasmic sperm injection, ICSI). All women were observed during the mid-luteal phase of cycle (T(0)) and on day 5 (T(1)), 7 (T(2)) and 9 (T(3)) of the ovarian stimulation.
  
  
  RESULTS
  Significant changes in fibrinolytic parameters from T(0) to T(3) of ovarian stimulation were found (CLT p=0.003; TAFI p=0.009 and PAI-1 p=0.003). CLT values, TAFI and PAI-1 concentrations significantly increased from baseline to T(1) (p<0.0001, p=0.01, p=0.005, respectively)(,) and decreased at T(2,) but remained higher than those at T(0). Moreover, at baseline overweight women showed longer CLT, higher TAFI and PAI-1 concentrations than normal weight women, as well as at T(1) two-fold longer CLT and higher PAI-1 concentrations were observed (p=0.001 and p=0.05, respectively). Significant differences of TAFI and PAI-1 concentrations during ovarian stimulation according to TAFI and PAI1 polymorphisms were observed.
  
  
  CONCLUSIONS
  This study shows alterations of fibrinolysis and suggests the contribution of TAFI and PAI1 genes in modulating fibrinolysis changes during the ovarian stimulation cycle.
authors: Department of Medical and Surgical Critical Care, Thrombosis Center, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors: Elena
authors: E
authors: Sticchi
authors: Ilaria
authors: I
authors: Romagnuolo
authors: Anna Paola
authors: AP
authors: Cellai
authors: Donatella
authors: D
authors: Lami
authors: Sandra
authors: S
authors: Fedi
authors: Domenico
authors: D
authors: Prisco
authors: Ivo
authors: I
authors: Noci
authors: Rosanna
authors: R
authors: Abbate
authors: Cinzia
authors: C
authors: Fatini
mesh_terms: D000328:Adult; D001779:Blood Coagulation Factors / Q000235:genetics* / Q000378:metabolism; D015992:Body Mass Index; D005260:Female; D005342:Fibrinolysis / Q000235:genetics / Q000502:physiology*; D006801:Humans; D007247:Infertility, Female / Q000097:blood* / Q000235:genetics* / Q000503:physiopathology; D010062:Ovulation Induction / Q000379:methods*; D020641:Polymorphism, Single Nucleotide; D055815:Young Adult
chemical_list: D001779:Blood Coagulation Factors