Venous Thromboembolism (VTE) and Assisted Reproductive Technologies (ART): A Complex Relationship

AbstractThrombosis in pregnancy is a major cause of maternal and fetal morbidity and mortality. Risk stratification of venous thromboembolism (VTE) during pregnancy is complex. The hypercoagulability observed in pregnant women can reduce bleeding during childbirth, but may cause thrombosis especially in the presence of additional prothrombotic risk factors such as antiphospholipid antibodies or genetic thrombophilic defects. The availability of large datasets allows for the identification of additional independent risk factors, including assisted reproductive technologies (ARTs), endometriosis, and recurrent pregnancy loss. Data on the risk of VTE linked to COVID-19 in pregnant women are very limited, but suggest that infected pregnant women have an increased risk of VTE. Current guidelines on the prevention and treatment of VTE in pregnancy are based on available, albeit limited, data and mainly present expert opinion. Low-molecular-weight heparins (LMWHs) are the mainstay of anticoagulation to be employed during pregnancy. Administration of LMWH for VTE treatment in pregnancy should be based on the personalized approach, taking into account a weight-based adjusted scheme. During gestation, due to physiological changes, in women at high risk of VTE, monitoring of anti-Xa activity is performed to ensure adequate LMWH dosing. As for the treatment duration for pregnant women with acute VTE, guidelines suggest that anticoagulation should be continued for at least 6 weeks postpartum for a minimum total duration of therapy of 3 months.

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P-003: Association between venous thromboembolism and assisted reproductive technologies: data from the RIETE Registry

Thrombosis Research ◽

10.1016/s0049-3848(17)30101-9 ◽

2017 ◽

Vol 151 ◽

pp. S110

Author(s):

P. Di Micco ◽

Á. Blanco-Molina ◽

D. Colaizzo ◽

A. Fontanella ◽

M. Amitrano ◽

...

Keyword(s):

Venous Thromboembolism ◽

Assisted Reproductive Technologies ◽

Reproductive Technologies

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Venous Thromboembolism in Women Undergoing Assisted Reproductive Technologies: Data from the RIETE Registry

Thrombosis and Haemostasis ◽

10.1055/s-0038-1673402 ◽

2018 ◽

Vol 118 (11) ◽

pp. 1962-1968 ◽

Cited By ~ 9

Author(s):

Elvira Grandone ◽

Pier Di Micco ◽

Michela Villani ◽

Donatella Colaizzo ◽

Carmen Fernández-Capitán ◽

...

Keyword(s):

Venous Thromboembolism ◽

Assisted Reproductive Technologies ◽

Reproductive Technologies ◽

Simultaneous Occurrence ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Vitro Fertilization ◽

Vein Thrombosis ◽

Deep Vein

AbstractVenous thromboembolism (VTE) during or after assisted reproductive technologies (ART) is predicted to rise due to the increased number of women undergoing this technique. We present data collected in the RIETE registry up to October 2016. Overall, 41 (0.6%) out of 6,718 women of childbearing age with VTE had an ART-related event. Most of them underwent autologous ART cycles; 23 had isolated deep vein thrombosis (DVT) (56.1%), 12 isolated pulmonary embolism (PE) (29.3%) and 6 simultaneous occurrence of both the events (14.6%). VTE occurred in 20 successful and 21 unsuccessful (i.e. not resulting in a clinical pregnancy) ART cycles. No recurrence was observed at 90 days. Logistic regression showed that isolated PE was significantly more frequent than DVT alone or combined with PE in unsuccessful in vitro fertilization (IVF) (odds ratio [OR]: 4.13, 95% confidence interval [CI]: 1.4–12.4), as well as in contraceptive users (OR: 2.96, 95% CI: 1.95–4.5) and in puerperium (OR: 1.96, 95% CI: 1.16–3.3). After grouping isolated PE and DVT + PE, we found that PE was significantly more frequent in women with unsuccessful IVF and higher body mass index (OR: 5.0, 95% CI: 1.2–20.7 and OR: 1.0, 95%CI: 1.0–1.1, respectively). These data document a higher risk of PE in unsuccessful cycles than in successful ones. The risk is higher than that observed during pregnancy, puerperium and contraception.

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P-059: Venous thromboembolism in unsuccessful cycles after assisted reproductive technologies (ART)

Thrombosis Research ◽

10.1016/s0049-3848(17)30157-3 ◽

2017 ◽

Vol 151 ◽

pp. S128

Author(s):

M. Villani ◽

D. Colaizzo ◽

F. Cappucci ◽

P. Totaro ◽

G. Favuzzi ◽

...

Keyword(s):

Venous Thromboembolism ◽

Assisted Reproductive Technologies ◽

Reproductive Technologies

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Re-imagining Reproduction: Unsettling Metaphors in the History of Imperial Science and Commercial Surrogacy in India

Somatechnics ◽

10.3366/soma.2015.0149 ◽

2015 ◽

Vol 5 (1) ◽

pp. 88-103 ◽

Cited By ~ 14

Author(s):

Kalindi Vora

Keyword(s):

Assisted Reproductive Technologies ◽

Reproductive Technologies ◽

The Body ◽

Body Parts ◽

Colonial History ◽

Women's Bodies ◽

Commercial Surrogacy ◽

Art Practices ◽

History Of ◽

Travel Industry

This paper provides an analysis of how cultural notions of the body and kinship conveyed through Western medical technologies and practices in Assisted Reproductive Technologies (ART) bring together India's colonial history and its economic development through outsourcing, globalisation and instrumentalised notions of the reproductive body in transnational commercial surrogacy. Essential to this industry is the concept of the disembodied uterus that has arisen in scientific and medical practice, which allows for the logic of the ‘gestational carrier’ as a functional role in ART practices, and therefore in transnational medical fertility travel to India. Highlighting the instrumentalisation of the uterus as an alienable component of a body and subject – and therefore of women's bodies in surrogacy – helps elucidate some of the material and political stakes that accompany the growth of the fertility travel industry in India, where histories of privilege and difference converge. I conclude that the metaphors we use to structure our understanding of bodies and body parts impact how we imagine appropriate roles for people and their bodies in ways that are still deeply entangled with imperial histories of science, and these histories shape the contemporary disparities found in access to medical and legal protections among participants in transnational surrogacy arrangements.

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