Predictive value of thrombopath determination in women with infertility and pregnancy complications

BackgroundA condition of maternal thrombophilia, either inherited or acquired, can compromise the success of implantation and foetal survival.MethodsMalfunctions in protein C pathway were evaluated using a novel assay [HemosIL ThromboPath (ThP)] in a case-control study of 172 women with a history of recurrent miscarriage or infertility and 86 age-matched unrelated fertile women.ResultsThrombophilia was ascertained in 13% of the cases. ThP values were lower in women either with or without thrombophilia compared to controls (both p < 0.0001). Abnormal ThP values (below the mean minus 1SD of controls) were found in 62% of cases compared to 12% of controls (p < 0.0001). Non-thrombophilic women who achieved spontaneous pregnancy had higher ThP values compared to those who did not (p < 0.05). Elevated ThP values were an independent predictor for pregnancy (p < 0.01) in women without thrombophilia. A decrease of ThP values was observed during pregnancy progression, which correlated with that of protein S (p < 0.05). Miscarriage or major complications occurred in women in whom ThP percent change was approximately 2-fold higher than that observed in women who achieved successful pregnancy (p < 0.05).ConclusionsThP might represent an efficient assay for screening women with pregnancy complications and might provide prognostic information during pregnancy progression.