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Semin Reprod Med 2011; 29(6): 540-547
DOI: 10.1055/s-0031-1293207
© Thieme Medical Publishers

Testing for Inherited Thrombophilia in Recurrent Miscarriage

Paulien G. de Jong1 , Mariëtte Goddijn2 , Saskia Middeldorp1
  • 1Department of Vascular Medicine, Center for Reproductive Medicine, Academic Medical Center, Amsterdam, The Netherlands
  • 2Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Academic Medical Center, Amsterdam, The Netherlands
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Publication History

Publication Date:
08 December 2011 (online)

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ABSTRACT

Approximately 1–5% of women trying to conceive experience recurrent miscarriage, and in 50% of these women, the cause of the preceding miscarriages is unknown. Inherited thrombophilias such as factor V Leiden mutation, prothrombin gene mutation (PT 20210A), and deficiencies of natural anticoagulants protein C, protein S, and antithrombin are associated with recurrent miscarriage. Knowledge of the association between inherited thrombophilia and recurrent miscarriage and of potential treatment options for improving chances of a live birth could tempt physicians to test for inherited thrombophilia in women with recurrent miscarriage. However, the strength of the association between inherited thrombophilia and recurrent miscarriage is not very strong, and more importantly, no evidence indicates that the use of anticoagulants improves the chance of live birth in these women. With the current state of evidence, testing for inherited thrombophilia should not lead to altered clinical management and therefore, should not be performed routinely in women with recurrent miscarriage but only in the context of scientific studies.

KEYWORDS

Pregnancy - inherited thrombophilia - adverse pregnancy outcome - recurrent miscarriage

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Paulien de JongM.D. 

Academic Medical Center

Amsterdam, Netherlands

Email: p.g.dejong@amc.uva.nl