Thrombotic risk during procreation medically assisted

Abstract

Use of assisted reproductive technology (ART) is increasing in many developed countries. Arterial and venous
thromboembolic complications are reported during ART
with an incidence of 0.1%. The development of these events
has been mainly ascribed to the presence of ovarian hyperstimulation syndrome (OHSS). Precise mechanisms by which
OHSS and exogenous hormonal stimulation used in ART
induce thromboembolic events remain unclear. However,
vascular endothelial growth factor secreted during OHSS,
high estradiol concentrations, and blood hyperviscosity play
a major role in inducing a prothrombotic state. Therefore,
before planning an ART, individual thromboembolic risk
should be assessed and thromboprophylaxis offered to high
risk patients. Prophylaxis should be initiated in women who
develop moderate-to-severe OHSS.