tacrolimus and Thrombophilia

What are the pregnancy outcomes after the OPtimization of Thyroid function, Immunity, and Uterine Milieu (OPTIMUM) treatment strategy in patients with repeated implantation failure (RIF)?. The 116 women with RIF after the OPTIMUM treatment strategy were 38.3 ± 3.8 years old and had an implantation failure history over 5 (3-19) ET cycles. Implantation testing identified impaired intrauterine circumstances in 75 women (64.7%), an aberrant elevated Th1/Th2 cell ratio in 56 women (48.3%), and thyroid abnormalities in 33 women (28.4%). Cumulative ongoing pregnancy rates including spontaneous pregnancy in the patients aged < 40 and ≥ 40 years were 72.7% and 45.5% within two ET cycles, respectively. The pregnancy outcomes in the OPTIMUM group were significantly higher than those in the control.. The OPTIMUM treatment strategy improved pregnancy outcomes in patients with RIF.

Topics: Adult; Anti-Bacterial Agents; Anticoagulants; Aspirin; Autoantibodies; Embryo Implantation; Endometritis; Female; Humans; Immunosuppressive Agents; Infertility, Female; Pregnancy; Pregnancy Outcome; Pregnancy Rate; Retrospective Studies; Risk Factors; Tacrolimus; Th1 Cells; Th2 Cells; Thrombophilia; Thyroid Diseases; Thyrotropin; Thyroxine; Vitamin D; Vitamin D Deficiency; Vitamins

Cyclosporine A (CsA) may increase the incidence of thrombotic events, but whether tacrolimus (Tc) has such effects is still unclear. The serotonergic system has been linked to the thrombotic effects of CsA, but a direct effect of CsA on serotonin-induced platelet aggregation has not been demonstrated because of methodological difficulties. We measured the effects of CsA and Tc on serotonin-induced platelet aggregate formation by particle counting using light scattering. CsA and Tc both enhanced serotonin-induced formation of small platelet aggregates, however, neither CsA nor Tc affected aggregation induced by high or low concentrations of ADP, with or without addition of a serotonin receptor antagonist. Both CsA and Tc enhance platelet aggregation induced via the serotonin pathway.

Topics: Adenosine Diphosphate; Bone Marrow Transplantation; Cyclosporine; Drug Synergism; Humans; Immunosuppressive Agents; In Vitro Techniques; Light; Platelet Aggregation; Scattering, Radiation; Serotonin; Serotonin Antagonists; Tacrolimus; Thrombophilia