menotropins and Activated-Protein-C-Resistance

We report a case of activated protein C (APC) resistance and deep calf vein thrombosis under controlled ovarian stimulation for in vitro fertilization. The thrombosis occurred before administration of human chorionic gonadotrophin for ovulation induction on the 8th day of hMG (human menopausal gonadotrophin). The patient was stimulated according to the long luteal protocol. Cases of arterial and venous thrombosis as a result of ovarian stimulations are reviewed.

Topics: Activated Protein C Resistance; Adult; Factor V; Female; Genetic Carrier Screening; Humans; Infertility, Female; Menotropins; Ovarian Hyperstimulation Syndrome; Ovulation Induction; Point Mutation; Risk Factors; Thrombophlebitis

To determine the effect of urinary versus recombinant FSH on platelet function and hemostatic variables in women undergoing controlled ovarian hyperstimulation cycles.. Randomized clinical study.. Major university-based infertility and in vitro fertilization unit and hemostasis laboratory.. Ten healthy women (in vitro study), and 24 women undergoing routine controlled ovarian hyperstimulation cycles (in vivo study), randomly assigned to receive either urinary (u-FSH) or recombinant gonadotropin (r-FSH).. In vitro study: effect of preincubation of plasma with u-FSH or r-FSH, in the presence or absence of estradiol, on platelet function and coagulation parameters. In vivo study: Changes in platelet function and coagulation parameters after treatment with u-FSH or r-FSH during controlled ovarian hyperstimulation cycles.. Platelet aggregation and ATP release, activated protein C resistance ratio, free protein S.. In vitro study: Platelet aggregation and ATP release were significantly inhibited by u-FSH relative to r-FSH in both the presence and absence of estradiol (P=.047). In vivo study: Platelet function was significantly inhibited after treatment with u-FSH (P=.05) but not with r-FSH. In both studies, small changes of minor clinical significance were noted in activated protein C resistance and free protein S levels.. The different platelet response to u-FSH and r-FSH may have clinical implications in selected patients, especially those at risk of thromboembolic complications, in decisions regarding the appropriate medication for controlled ovarian hyperstimulation cycles.

Topics: Activated Protein C Resistance; Adenosine Triphosphate; Adult; Blood Platelets; Drug Therapy, Combination; Estradiol; Female; Follicle Stimulating Hormone; Follicle Stimulating Hormone, Human; Hemostasis; Humans; Infertility; Menotropins; Ovulation Induction; Platelet Aggregation; Protein S; Recombinant Proteins