A question that I occasionally hear is whether inherited tendencies to clot abnormally (thrombophilias) are a cause of infertility or early pregnancy loss. Most people asking this question have gotten this notion from surfing the internet. Our group’s opinion on the subject has been that these conditions are not major factors in either early pregnancy loss or infertility.
A study in the December 2009 online edition of the medical journal “Fertility & Sterility” found no significant difference in the prevalence of three genetic mutations associated with the increased risk of thrombophilia (Factor V Leiden G1691A, prothrombin G20210A, and methylenetetrahydrofolate reductase [MTHFR] C677 T) in 100 infertile women with unexplained infertility when compared with 200 control fertile women without an infertility history.
There can be issues in late pregnancy in women who are homozygous (have two copies of the mutant gene) for some of these conditions and these women may require significant anticoagulation. But prevailing current thinking is that women with infertility or early pregnancy loss do not need significant anticoagulation even if homozygous for these genetic mutations.
This is important because anticoagulation beyond one baby aspirin a day may result in health and potentially even life-threatening complications
