Obstetrics and Gynecology
Malihe Afiat; Nayere Khadem; Behnaz Ansari; Fedyeh Haghollahi; Mohadese Dashtkoohi; Mohammad Sadeq Najafi; Mohammad Dashtkoohi; MirFarbod Hojati Bagheri; Seyede Houra Mousavi Vahed
Articles in Press, Accepted Manuscript, Available Online from 05 February 2024
Abstract
Background and Objective: The effectiveness of aspirin and heparin in improving live birth rates in unexplained recurrent pregnancy loss remains uncertain, and further research is needed on using low molecular weight heparins (LMWH) through randomized clinical trials. This study aims to assess the impact ...
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Background and Objective: The effectiveness of aspirin and heparin in improving live birth rates in unexplained recurrent pregnancy loss remains uncertain, and further research is needed on using low molecular weight heparins (LMWH) through randomized clinical trials. This study aims to assess the impact of enoxaparin, an LMWH, and its outcomes in women with URPL.
Methods: This study presents a single-blinded randomized clinical trial involving 80 women with URPL and no history of thrombophilia. The participants were referred to the Infertility Clinic at Imam Reza Hospital (Milad Center) between March 2018 and February 2019. During the sixth week of gestation, the participants were assigned randomly to two groups. The treatment group (n = 40) received a daily subcutaneous injection of 40 mg of enoxaparin, while the control group (n = 40) received routine pregnancy care. Maternal and neonatal demographic data, pregnancy outcomes, complications, and live birth rates were recorded and subsequently compared between the two groups.
Results: A total of 80 eligible women were enrolled in the study, with equal distribution between the treatment and control groups. There were no significant differences in previous pregnancies or miscarriages between the groups, and the live birth rate was about 85% in both groups. The occurrence of pregnancy complications was significantly higher in the treatment group compared to the control group (38.2% VS. 5.7%; p = 0.021).
Conclusion: Treatment with enoxaparin in women with unexplained recurrent pregnancy loss and no history of thrombophilia did not improve the pregnancy outcome nor decrease pregnancy complications.
Reproductive Medicine
Mohammad Ebrahim Parsa Nejad; Elnaz Fathi Kaljahi; Sareh Dousfatemeh
Volume 9, Issue 1 , January and February 2024, , Pages 63-69
Abstract
Background & Objective: In this placebo-controlled randomized clinical trial, we aimed to investigate the effect of low molecular weight heparin (LMWH) on the assisted reproductive technology (ART) success rate in women without thrombophilic disorder undergoing assisted reproductive technology.Materials ...
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Background & Objective: In this placebo-controlled randomized clinical trial, we aimed to investigate the effect of low molecular weight heparin (LMWH) on the assisted reproductive technology (ART) success rate in women without thrombophilic disorder undergoing assisted reproductive technology.Materials & Methods: The study population consisted of 276 patients referred to the infertility center at Shiraz University of Medical Sciences and who underwent in vitro fertilization (IVF) for the first time. Patients were randomly assigned into two groups (control group = 137 women who underwent IVF and received placebo; case group = 139 women who underwent IVF and received LMWH). The case group was treated with LMWH and the control group received placebo. Specifications for egg harvesting, processing sperm, the number of fertilized eggs and embryos, the number of frozen and transferred embryos, and the IVF outcome were assessed.Results: The mean age of subjects was 32.59 ± 4.41 years old in the case group and 32.62 ± 5.18 in the control group (p = 0.955). The final outcome of IVF treatment in the control group was treatment failure (62%), clinical pregnancy (21.2%), chemical pregnancy (5.9%), and live birth (7.3%), while in the case group, it was treatment failure (48.2 %), clinical pregnancy (21.6%), chemical pregnancy (2.2%), and live births (28.1%). There was a significant difference in IVF outcome in the two groups (P < 0.001).Conclusion: Given the significant difference in the number of live births and reduction of pregnancy complications in the LMWH group, it can be concluded that LMWH prophylaxis may be effective in ART success.