Risk of Thrombosis in Women Undergoing In Vitro Fertilization: A Narrative Review

Area of Science:

• Reproductive Medicine
• Hematology
• Obstetrics

Background:

• Thrombosis is a rare complication associated with In Vitro Fertilization (IVF).
• Ovarian hyperstimulation syndrome (OHSS) significantly increases the risk of thrombosis following IVF.
• Understanding the epidemiology and pathophysiology of IVF-related thrombosis is crucial for patient safety.

Purpose of the Study:

• To review the current literature on the association between IVF treatments and thrombosis.
• To focus on the epidemiological data and underlying pathophysiology of these events.
• To identify key risk factors predisposing women to thromboembolic complications during and after IVF.

Main Methods:

• Narrative review of existing scientific literature.
• Analysis of epidemiological data on IVF-related thrombosis incidence.
• Discussion of pathophysiological mechanisms linking IVF, OHSS, and thrombosis.

Main Results:

• Thrombosis is a rare IVF complication with an incidence of approximately 0.2%, markedly elevated by OHSS.
• Arterial thrombosis, often early and linked to OHSS, is rare; venous thrombosis, though more common, is also rare overall.
• Upper body venous thrombosis is frequently observed, and thrombotic risk is highest in the first trimester of IVF-conceived pregnancies.

Conclusions:

• While rare, thrombosis is a significant IVF-related complication, particularly when OHSS is present.
• Risk factors including OHSS, thrombophilia, obesity, advanced maternal age, and PCOS increase thromboembolic risk.
• Awareness and management of these risk factors are essential for mitigating thrombosis in women undergoing IVF.