Abstract
Assisted reproductive therapy (ART) increases the risk of venous thrombosis (VT) by
2- to 4-fold, whereas pregnancy increases the risk by 5- to 10-fold. Women with a
history of VT undergoing ART are often suggested thromboprophylaxis. The literature
is scarce and international guidelines are lacking. We made a review of the literature
and base our suggestions primarily on expert opinions. We suggest women with a prior
VT to use low-molecular-weight heparin as thromboprophylaxis starting from ovarian
stimulation, throughout pregnancy, and 6 weeks postpartum. Assessment of VT risk should
be done prior to ART. Adjustment of treatment to minimize the thrombotic risk, such
as preventing ovarian hyperstimulation syndrome, single-embryo transfer, cryopreservation,
and transfer of frozen embryos instead of fresh embryo in high-risk women, is suggested.
Women with previous arterial thrombosis should continue aspirin during ART treatment,
pregnancy, and postpartum.
Keywords
venous thrombosis - arterial thrombosis - assisted reproductive therapy - in vitro
fertilization - previous thromboembolic disease
