LMWH in IVF - Biomarkers and benefits.

Area of Science:

• Reproductive immunology
• Thrombophilia in pregnancy
• Assisted reproductive technologies

Background:

• Coagulation activation is biologically plausible in in vitro fertilization (IVF) failures and recurrent pregnancy loss (RPL).
• Low-molecular-weight heparin (LMWH) has not proven effective in preventing RPL based solely on clinical outcomes.
• RPL is a heterogeneous condition, necessitating identification of specific underlying mechanisms for targeted treatment.

Purpose of the Study:

• To investigate the association between the annexin A5 M2 haplotype (ANXA5 M2) and IVF outcomes.
• To evaluate the potential of ANXA5 M2 as a biomarker for stratifying patients for LMWH treatment.
• To determine if LMWH can counteract adverse effects associated with ANXA5 M2 carriage in IVF and placenta-mediated pregnancy complications (PMPC).

Main Methods:

• A pragmatic observational study involving IVF couples screened for ANXA5 M2 carriage.
• Treatment with LMWH for couples identified as M2 carriers.
• Comparison of live birth rates between screened/treated and unscreened/untreated groups.

Main Results:

• A live birth rate of 37.9% was observed in the screened and LMWH-treated IVF group.
• This success rate was comparable to an unscreened, untreated group with a better baseline prognosis.
• The findings suggest LMWH may mitigate the negative impact of M2 carriage.

Conclusions:

• The ANXA5 M2 haplotype is a potential biomarker for identifying patients who may benefit from LMWH treatment in IVF and PMPC.
• Stratified treatment using this biomarker warrants further investigation for improving reproductive outcomes.
• Targeted LMWH therapy based on genetic screening could offer a more personalized approach to managing RPL and IVF failures.