The procoagulant status. Hypercoagulability as a risk factor of primary and secondary infertility

Abstract

Thrombophilia is a disorder that makes patients susceptible to intravascular thrombosis that may increase the risk of developing a pregnancy on a known pathology. The female patient diagnosed with hypoplastic uterus and hereditary thrombophilia had a favorable evolution under properly administered anticoagulant treatment. The homozygous status for the C677T mutation may lead to an increase in plasma homocysteine levels, especially in pregnant women, being an associated risk factor for thrombosis. The risk of developing intravascular thrombosis requires primary prevention measures by adding D-dimers in the early diagnostic algorithm, being the most accurate marker of hypercoagulability and endogenous fibrinolysis. The corroboration of the hypercoagulability status with the results of genotyping, the frequencies of the minor/major alleles studied, single mononucleotide polymorphisms (SNPs) and the establishment of preventive therapy, aims to prevent intravascular thrombosis and thromboembolic phenomena.

The influence of SARS-CoV-2 on the immune system elements and on the placental structure. Clinical, histological and immunohistochemical study

“…In terms of age, we selected patients between 20 and 35 years old to avoid being associated with placental changes caused by chronic pathologies, common at advanced ages [ 40 , 41 , 42 , 43 , 44 , 45 ]. However, between the two groups (C+ and C-), we noticed that the average age of the patients in the C+ group was approximately four years lower compared to the C- group.…”

Reduced Numbers of Nerve Fibers in the Oviduct Ampulla of Women with Tubal Ectopic Pregnancy

“…On the other hand, the reduction of PGP9.5 and S100 in the mucosal and muscular layers of the FTs suggests that injury to the nerve fibers in the ampulla tissue may negatively impact on the release of transmitters including acetylcholine (ACh), adrenaline, noradrenaline, and the modulation of the nerve reflex. These events may reduce oviduct motility by influencing the vascular muscle contractility, the tubal smooth muscle, ciliary beat activity and the secretory processes of the mucosal epithelial cells [3], thus resulting in the pathogenesis of FP.…”

“…Excessive suction or curettage can also readily cause damage to the nerves between the endometrium and the myometrium. In a previous study, Neamtu et al [3] suggested that the motility of the FTs was influenced by both nerves and hormones. Several neuropeptides, such as neuropeptide Y-immunoreactivity (NPY), have been de-tected in nerve fibers in the FTs [4].…”

ESHRE good practice recommendations on recurrent implantation failure

“…Inherited thrombophilia comprises conditions in which a genetic mutation affects the amount or the function of a protein in the coagulation pathway. Mutations in several genes have been shown to be involved: G1619A (factor V Leiden), R2 H1299R (factor V Leiden polymorphism), A1298C (methylenetetrahydrofolate reductase (MTHFR) enzyme mutation), C677T (MTHFR polymorphism), V34L (factor XIII polymorphism), G20210A (mutation of the prothrombin gene), a/b L33P (ribosomal polymorphism of MTHFR enzyme), and 4G / 5G (plasminogen activator inhibitor-1 (PAI-1)) ( Neamţu et al , 2021 ).…”

“…Inherited thrombophilia has been implicated in early pregnancy loss and implantation failure, by impairment of the vascular changes necessary for successful pregnancy ( Qublan et al , 2006 ; Neamţu et al , 2021 ).…”