Low-Molecular-Weight Heparin (LMWH) in Women with Repeated Implantation Failure

Excerpt

Despite the initial dramatic improvements in success rates and significant increments in uptake of assisted reproduction techniques (ARTs), the live birth rate resulting from these techniques has recently plateaued [1]. Greater emphasis is now being placed on experimental strategies to further improve oocyte and embryo number and quality, implantation rates, and successful transition to live births. One such strategy is the use of low-molecular-weight heparin (LMWH) which, as a product having significant impact on live birth rates in women with acquired thrombophilia [2, 3], is now being considered as a potential therapy for all ART patients. Although the effect of LMWH on trophoblast biology has not been studied extensively, given the available data suggesting a possible beneficial effect of LMWH on embryo implantation, we use LMWH extensively in ART cycles especially in the group of patients with recurrent implantation failures RIF with consistently uncompromised embryo quality. These benefits will include reductions in the thrombotic risks associated with exogenous gonadotropins; and, given the accumulating evidence that the beneficial effects of LMWH are not solely mediated via an anticoagulant effect [4], the potential for LMWH being used for optimizing implantation and trophoblast development. …