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Antikoagulation und assistierte Reproduktion

Verbesserte Schwangerschafts- und Austragungsraten durch Aspirin und Heparin?

Anticoagulation and assisted reproduction

Improved pregnancy and birth rates through additional therapy with aspirin and heparin?

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Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Trotz signifikanter Verbesserungen der Behandlungsprotokolle sowie der Labortechniken beträgt die Schwangerschaftsrate bei Methoden der assistierten Reproduktion pro ICF/ICSI-Versuch in Deutschland maximal 40%, die „Baby-take-home-Rate“ liegt im Mittel bei etwa 20%. Es ist daher verständlich, dass Therapieversuche zur Verbesserung von Schwangerschafts- und Austragungsrate zur Anwendung kommen. Dabei wird unter anderem auch die prophylaktische Gabe von Aspirin und/oder Heparin zur Vermeidung eines Implantationsversagens – zum Teil unabhängig von einer möglichen Thrombophilie der Patientin – propagiert. Diese Anwendungen sollen im Rahmen dieser Übersicht dargestellt und unter Berücksichtigung aktueller Studien und Metaanalysen kritisch diskutiert werden. Zudem sollen mögliche Zusammenhänge zwischen maternaler Thrombophilie und einem Implantationsversagen untersucht werden.

Abstract

The pregnancy rate after methods of assisted reproduction attains a maximum rate of 40% in Germany, despite significant improvements in treatment protocols and laboratory techniques. The baby-take-home rate lies at a disappointing average rate of 20%. Understandably, therefore, various approaches pursued to improve the pregnancy and delivery rates after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). The use of aspirin and/or heparin has been suggested to help avoid implantation failure, partially irrespective of maternal thrombophilia. This approach is presented and critically discussed in this overview, taking account of current studies and meta-analyses. Furthermore, possible associations between maternal thrombophilic disorders and implantation failure are investigated.

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Authors and Affiliations

  1. Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Schleswig-Holstein – Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    M.K. Bohlmann, A. Hornemann, M. Thill, K. Diedrich & D.W. Luedders

  2. Klinik und Poliklinik für Angiologie, Departement Herz und Gefäße, Universitätsspital Bern, Bern, Schweiz

    J. Ortmann

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  1. M.K. Bohlmann
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  2. A. Hornemann
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Correspondence to M.K. Bohlmann.

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Bohlmann, M., Hornemann, A., Ortmann, J. et al. Antikoagulation und assistierte Reproduktion. Gynäkologische Endokrinologie 7, 74–79 (2009). https://doi.org/10.1007/s10304-008-0294-1

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