Heparin and Fertility

Jun 29 2011

This post has been modified according to the latest updated use of Heparin in Assisted Reproduction treatments. Please check out the following link to see the latest publication on “Heparin as a Treatment for Repeat Miscarriages or Implantation Failure”:

http://www.institutobernabeu.com/foro/en/2012/07/09/heparin-as-a-treatment-for-repeat-miscarriages-or-implantation-failure/

Since the discovery of Heparin, an effective anti-coagulant agent, it has been used in many fields of medicine. It has recently been used in fertility treatments (IVF, egg donation, etc.) in two ways: firstly as a preventive treatment for thromboembolic phenomena and secondly as an adjunctive therapy in cases of implantation failure or repeat miscarriage.

Heparin as a thrombosis prevention:

There is no doubt that Heparin is the treatment of choice here but in what type of cases do we need this treatment? As we explain later, there is a close relationship between these disorders (thrombophilia) and procoagulant phenomena and repeat miscarriage or implantation failure.

Thrombophilia (the tendency to form thrombi) can be inherited (patients with Factor V Leiden or a deficiency of Proteins C and S) or due to diseases like Antiphospholipid Syndrome (APS).

Thrombi occur and can manifest in many ways:

Early and late miscarriage, intrauterine foetal death, placental abruption, growth retardation.

Due to good results this treatment is indicated to treat all of these conditions as well as for repeat miscarriage. Heparin treatment is used for the treatment of repeat miscarriage or implantation failure for an unknown cause:

Although experiments on rats suggested a beneficial effect of this treatment in patients with repeat miscarriage or with implantation failure, the reality is that all research on humans does not show the desired results. In addition, the absence of side effects cannot be assured. It is also NOT RECOMMENDED for use in patients without a diagnosis of ofthrombophilia.

Keep in mind that applying treatments with potential side effects and with no real evidence of efficiency is irresponsible and could be harmful.

Dr Belén Moliner, Gynaecologist at Instituto Bernabeu.

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3 responses so far

  • Isobel Yeomans says:

    APS, or Hughes Syndrome, is – in my experience – still very underdiagnosed. Many women are fine on low dose aspirin so, why is heparin better?
    Many thanks

    Isobel Yeomans

    • Dear Isobel,

      I agree with you that the primary antiphospholipid syndrome is still unknown to many professionals and therefore it is often misdiagnosed, especially with obstetrics manifestations.

      To answer you more specifically, we should first provide an overview of what the disease implies. It is an autoimmune syndrome that involves hypercoagulability, meaning the tendency to form blood clots. In obstetrics, it mainly manifests in the form of miscarriages, and this is due to the formation of clots and strokes in the placenta, which prevent the correct formation of the fetus.

      Aspirin is an anti-platelet agent, and platelets are involved in the early stages of thrombus formation. Therefore, it is primarily used for prevention.

      Heparin is an effective anti-coagulant agent that acts at the clotting level, preventing blood from pooling and making it somewhat more diluted.

      Normally we use both treatments for serious diseases such as the antiphospholipid syndrome, since both help prevent and treat the disease.

      I hope I have been helpful and I appreciate your confidence in asking us about such a delicate matter.

      My best wishes,

      Dr. Belen Moliner

  • TTT says:

    Congrats for your helpful Blog.

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