title: Plasma concentrations of D-dimer and outcome of in vitro fertilization.
abstract: BACKGROUND
  The activation of blood coagulation could contribute to the failure of in-vitro fertilization (IVF) techniques. The aim of this study was to assess the predictive value of D-dimer levels for pregnancy outcome in women undergoing IVF.
  
  
  RESULTS
  A prospective study was performed in 105 women undergoing IVF. D-dimer was measured before and one week after the administration of recombinant human chorionic gonadotropin (r-hCG). The primary outcome of the study was clinical pregnancy. The mean age was 36 years (range 26 to 43 years). The main indications for IVF were infertility due to a tubaric (n = 21, 20%) or male factor (n = 37, 35%) and idiopathic infertility (n = 30, 29%) which altogether accounted for 84% of the total. Clinical pregnancy was achieved by 40/105 (38%) women of whom 32 (80%) delivered a live child. On the day of r-hCG administration, D-dimer concentrations were significantly higher in patients not achieving a clinical pregnancy (141 ng/dL vs. 115 ng/dL, p = 0.035) which remained statistically significant after correction for age and indications for IVF in multivariable analysis (p = 0.032). One week after r-hCG, the levels of D-dimer were significantly increased both in women with and without a clinical pregnancy with no differences between the groups (748 ng/dL vs. 767 ng/dL, p = 0.88).
  
  
  CONCLUSIONS
  D-dimer concentrations seem to predict a higher risk of pregnancy failure in women undergoing IVF. If confirmed in future prospective studies, D-dimer could help identifying a group of patients who could benefit from prophylaxis to increase the pregnancy success rate.
authors.affiliation: Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy ; Department of Vascular Medicine, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: Marcello
authors.initials: M
authors.lastname: Di Nisio
authors.affiliation: Department of Medicine and Aging, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Porreca
authors.affiliation: Department of Medicine and Aging, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Di Donato
authors.affiliation: Department of Medicine and Aging, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy.
authors.forename: Gian Mario
authors.initials: GM
authors.lastname: Tiboni
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D007247:Infertility, Female / Q000097:blood* / Q000628:therapy; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D
keywords: Clinical pregnancy; D-dimer; Hypercoagulability; In-vitro fertilization