title: Is tissue factor pathway inhibitor a marker of procoagulable status in healthy infertile women undergoing ovarian stimulation for assisted reproduction?
abstract: Increased serum estradiol levels occurred during ovarian stimulation for assisted reproduction. Tissue factor pathway inhibitor (TFPI) plays a relevant role in regulating haemostatic equilibrium, and its decrease has been documented in conditions in which blood coagulation occurs. We investigated TFPI concentrations and coagulative pathway in healthy infertile women undergoing ovarian stimulation. We investigated 27 healthy infertile women, median age 37 (25-41) years, undergoing ovarian stimulation, observed during the mid-luteal phase of cycle (T0) and on day 5 (T1), and between day 7 and 9 (T2) of ovarian stimulation. Coagulative pathway was assessed by a global test [endogenous thrombin potential, (ETP)] and TFPI concentrations. TFPI values progressively and significantly decreased throughout the ovarian stimulation procedure (P = 0.03), contemporarily estradiol levels progressively and significantly increased from baseline to T2 (P < 0.0001). A significant negative correlation between changes in estradiol and TFPI levels was observed (P = 0.03). As concerns ETP parameters a significant increase of ETP (mA) and Cmax (mA/min) throughout the ovarian stimulation cycle was found (P = 0.003 and P = 0.002, respectively). TFPI values progressively and significantly decreased throughout the ovarian stimulation, and negatively correlated with estradiol, thus suggesting that TFPI may represent one of the main 'actors' involved in the hypercoagulable status, occurring during assisted reproduction. The relationship between TFPI and estradiol levels might contribute to the knowledge of mechanisms able to modify a quite milieu into a prothrombotic status. Nevertheless, the small number of individuals investigated might influence the relevance of our results.
authors.affiliation: aDepartment of Clinical and Experimental Medicine, Thrombosis Center, University of Florence, Azienda Ospedaliero-Universitaria Careggi bFiorgen Foundation cDepartment of Experimental and Clinical Biomedical Sciences, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Romagnuolo
authors.forename: Elena
authors.initials: E
authors.lastname: Sticchi
authors.forename: Sandra
authors.initials: S
authors.lastname: Fedi
authors.forename: Anna P
authors.initials: AP
authors.lastname: Cellai
authors.forename: Donatella
authors.initials: D
authors.lastname: Lami
authors.forename: Agatina
authors.initials: A
authors.lastname: Alessandrello Liotta
authors.forename: Angela
authors.initials: A
authors.lastname: Rogolino
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cioni
authors.forename: Ivo
authors.initials: I
authors.lastname: Noci
authors.forename: Rosanna
authors.initials: R
authors.lastname: Abbate
authors.forename: Cinzia
authors.initials: C
authors.lastname: Fatini
mesh_terms: D000328:Adult; D001777:Blood Coagulation / Q000502:physiology*; D001780:Blood Coagulation Tests / Q000379:methods; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000097:blood* / Q000628:therapy*; D008074:Lipoproteins / Q000097:blood*; D010062:Ovulation Induction / Q000379:methods*
chemical_list: D008074:Lipoproteins; C051928:lipoprotein-associated coagulation inhibitor