FEATURES OF HEMOSTASIS SYSTEM IN WOMEN WITH THROMBOPHILIA AS ONE OF CAUSAL FACTORS FOR UNSUCCESSFUL ATTEMPTS IN EXTRACORPOREAL FERTILIZATION

Abstract

Excessive activation of blood coagulation, imbalance in coagulation potential, presence of endotheliopathies, local hemorrhages and microthrombi in the area of blastocyst invasion may be common in the mechanism of implantation losses in thrombophilia. One of the ways to optimize the results of extracorporeal fertilization is the prevention of thrombotic complications. Despite the achievements of modern morphology, some issues concerning the pathogenesis of infertility and habitual miscarriage remain poorly understood. To assess the system of hemostasis in women with thrombophilia as one of the causative factors of unsuccessful attempts in extracorporeal fertilization, a study of 63 patients was conducted, which included hormonal, genetic studies, HLA−typing, ultrasonography, hysterosalpingography, determination of infectious profile and was performed depending on clinical situation. The study of the hemostasis system included the determination of total coagulation potential, analysis of primary hemostasis, fibrinolytic system, the state of intravascular hemocoagulation and antiplasmin potential of blood. The state of intravascular hemocoagulation was assessed by the concentration in blood plasma of pathological hemocoagulants, i.e. soluble complexes of fibrin monomers and fibrinogen−fibrin degradation products. The results of the study showed that in women with a thrombophilia history and unsuccessful attempts in extracorporeal fertilization, there is a pathological activation of the hemostasis system, which plays a significant role in the pathogenesis of unsuccessful fertilization attempts. In thrombophilia, a subclinical form of chronic disseminated intravascular coagulation develops, the leading link in the development of which is the activation of platelet−vascular hemostasis with subsequent involvement into the process of coagulation potential due to a decrease in the anticoagulant blood system. Key words: thrombophilia, hemostasis system, extracorporeal fertilization, infertility.