Multiple thrombophilic single nucleotide polymorphisms lack a significant effect on outcomes in fresh IVF cycles: an analysis of 1717 patients

Abstract

Purpose The aim of the study is to determine if thrombophilic single nucleotide polymorphisms (SNPs) affect outcomes in fresh in vitro fertilization (IVF) cycles in a large general infertility population. Methods A prospective cohort analysis was performed at a university-affiliated private IVF center of female patients undergoing fresh non-donor IVF cycles. The effect of the following thrombophilic SNPs on IVF outcomes were explored: factor V (Leiden and H1299R), prothrombin (G20210A), factor XIII (V34L), β-fibrinogen (-455G→A), plasminogen activator inhibitor-1 (4G/5G), human platelet antigen-1 (a/b9L33P), and methylenetetrahydrofolate reductase (C677T and A1298C). The main outcome measures included positive pregnancy test, clinical pregnancy, embryo implantation, live birth, and pregnancy loss. Results Patients (1717) were enrolled in the study, and a total of 4169 embryos were transferred. There were no statistically significant differences in positive pregnancy test, clinical pregnancy, embryo implantation, live birth, or pregnancy loss in the analysis of 1717 patients attempting their first cycle of IVF. Receiver operator characteristics and logistic regression analyses showed that outcomes cannot be predicted by the cumulative number of thrombophilic mutations present in the patient. Conclusions Individual and cumulative thrombophilic SNPs do not affect IVF outcomes. Therefore, initial screening for these SNPs is not indicated.

Association between in vitro fertilization outcomes and inherited thrombophilias: a meta-analysis

“…Two articles [15,20] reported FVL mutation and the result of heterogeneity test was I 2 = 96.0 %, P < 0.00001, and no significant differences (RR = 1.57, 95 % CI 0.47-5.27, P = 0.46) were observed between the two groups. Two articles [18,20] reported PGM mutation and the heterogeneity test results was I 2 = 0.0 %, P = 0.8, and no significant difference (RR = 0.83, 95 % CI 0.64-1.09, P = 0.18) was observed. One study reported FVL/ PGM mutation (RR = 1.14, 95 % CI 0.62-2.12, P = 0.67) and one reported FVL/APCR mutation (RR = 1.30, 95 % CI 1.03-1.63, P = 0.…”

“…As shown in Fig. 2, four studies [14,17,19,20] reported MTHFR (C677T) mutation and the results showed that MTHFR (C677T) mutation in inherited thrombophilia was not associated with CPR. The homogeneity analysis (P = 0.52, and I 2 = 0.0 %) and effect size merge (RR = 1.05, 95 % CI 0.97-1.14, P = 0.023) showed that there was no significant difference in MTHFR (C677T) mutation between the mutation group and control group.…”

“…The homogeneity analysis (P = 0.52, and I 2 = 0.0 %) and effect size merge (RR = 1.05, 95 % CI 0.97-1.14, P = 0.023) showed that there was no significant difference in MTHFR (C677T) mutation between the mutation group and control group. Three articles [14,19,20] reported MTHFR (A1298C) mutation and no heterogeneity (I 2 = 0.0 %, P = 0.39) or significant difference (RR = 1.03, 95 % CI 0.95-1.12, P = 0.50) in MTHFR (A1298C) was observed between the two groups. Two articles [15,20] reported FVL mutation and the result of heterogeneity test was I 2 = 96.0 %, P < 0.00001, and no significant differences (RR = 1.57, 95 % CI 0.47-5.27, P = 0.46) were observed between the two groups.…”

“…Three articles [14,19,20] reported MTHFR (A1298C) mutation and no heterogeneity (I 2 = 0.0 %, P = 0.39) or significant difference (RR = 1.03, 95 % CI 0.95-1.12, P = 0.50) in MTHFR (A1298C) was observed between the two groups. Two articles [15,20] reported FVL mutation and the result of heterogeneity test was I 2 = 96.0 %, P < 0.00001, and no significant differences (RR = 1.57, 95 % CI 0.47-5.27, P = 0.46) were observed between the two groups. Two articles [18,20] reported PGM mutation and the heterogeneity test results was I 2 = 0.0 %, P = 0.8, and no significant difference (RR = 0.83, 95 % CI 0.64-1.09, P = 0.18) was observed.…”

“…No article was obtained with manual retrieval. Finally, 7 articles [14][15][16][17][18][19][20] were included in this meta-analysis (Table 1). These included studies were published between 2007 and 2015 with the ages of subjects between 30.9 and 36.2.…”