Evaluation of Thrombophilic Factors in Women with PCOS

Moeini, Ashraf; Sarrafioun, Fariba; Ziaei, Saeideh; Faghihzadeh, Soghrat

Evaluation of Thrombophilic Factors in Women with PCOS

Vol. 11, Issue 2, / July-September 2010
(pages 97-103)

Ashraf Moeini: 1- Royan Research Center, Endocrinology & Infertility Department, Tehran, Iran; 2- Department of Gynecology and Obstetrics ,Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Fariba Sarrafioun: - Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
Saeideh Ziaei: - Midwifery Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
Soghrat Faghihzadeh: - Department of Biostatistics, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran

Received: 1/24/2009 Accepted: 11/18/2009 - Publisher : Avicenna Research Institute

Other Format

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is associated with insulin-induced elevations of plasminogen activator inhibitor (PAI-1), the most potent inhibitor of fibrinolysis. Hypofibrinolysis due to increased PAI-1 levels in PCOS patients bears a high risk for miscarriage and some other pregnancy complications which are probably due to increased thrombophilic states. In this study we compared thrombophilic factors in women with PCOS with those of healthy women. Materials and Methods: This analytical study was performed on 123 infertile women with PCOS as the case group, and 73 women non-PCOS women with male factor infertility as the control group. All the individuals attended Rouin Tan Arsh Hospital for receiving fertility treatment in Tehran, Iran during 2008. Blood samples were taken from both groups on the third day of menstrual cycle for the evaluation of protein S, activated protein C resistance (APC-R), hemocysteine, FSH, LH, prolactin, testosterone, FBS and 2-hr GTT. Results: The mean protein S and APC-R values were lower in the case group compared to the controls, but the differences were not statistically significant (p = 0.752 and p = 0.603, respectively). The mean hemocysteine value was higher in the control than the case groups (13.25 mmol/l vs. 12.49 mmol/l, respectively) but this difference was not significant either (p = 0.157). PCOS and older age tended to elevate hemocysteine (p < 0.05). Conclusion: Comparison of thrombophilic factors in women with PCOS and women without the disease showed no significant statistical differences. PCOS and older age seemed to raise the risk for abnormal changes in hemocysteine levels.

Keywords: Activated protein C resistance, Factor V Leiden, Plasminogen activator inhibitor 1 (PAI-1), Polycystic ovary syndrome, Protein S, Thrombophilia, Homocysteine

To cite this article:

Moeini A, Sarrafioun F, Ziaei S, Faghihzadeh S. Evaluation of Thrombophilic Factors in Women with PCOS. J Reprod Infertil. 2010;11(2):97-103.

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References

Tsanadis G, Vartholomatos G, Korkontzelos I, Avgoustatos F, Kakosimos G, Sotiriadis A, et al. Polycystic ovarian syndrome and thrombophilia. Hum Reprod. 2002;17(2):314-9. [PubMed]
Speroff L, Fritz MA. Clinical Gynecologic Endo-crinology and Infertility. 7th ed. USA: A Wolters Kluwar Company; 2005. p. 1086-8.
Kujovich JL. Thrombophilia and pregnancy complications. Am J Obstet Gynecol. 2004;191 (2):412-24. [PubMed]
Cunningham FG, Gant NF, Levono KJ, Gilstrap LC, Haunt JC, Wenstrom KD. Williams Obstetrics. 22nd ed. New York: Mc Graw-Hill; 2005. p. 1074-8.
James DK, Weneri CP, Steer PhJ, Gonik B. High Risk Pregnancy: Management Options. 3rd ed. USA: Elsevier Inc; 2006. p. 926-41.
Hervig T, Haram K, Sandset PM. [Deep venous thrombosis in pregnant women]. Tidsskr Nor Laegeforen. 1998;118(26):4093-7. Norwegian. [PubMed]
Ridker PM, Hennekens CH, Selhub J, Miletich JP, Malinow MR, Stampfer MJ. Interrelation of hyperhomocyst(e)inemia, factor V Leiden, and risk of future venous thromboembolism. Circulation. 1997; 95(7):1777-82. [PubMed]
Younis JS, Ohel G, Brenner B, Ben-Ami M. Familial thrombophilia--the scientific rationale for thrombophylaxis in recurrent pregnancy loss? Hum Reprod. 1997;12(7):1389-90. [PubMed]
James AH. Prevention and management of venous thromboembolism in pregnancy. Am J Med. 2007; 120(10 Suppl 2):S26-34. [PubMed]
Hague WM, North RA, Gallus AS, Walters BN, Orlikowski C, Burrows RF, et al. Anticoagulation in pregnancy and the puerperium. Med J Aust. 2001;175(5):258-63. [PubMed]
Franks S, Gharani N, Waterworth D, Batty S, White D, Williamson R, et al. The genetic basis of polycystic ovary syndrome. Hum Reprod. 1997;12 (12):2641-8. [PubMed]
Ghosh K, Shetty S, Vora S, Salvi V. Successful pregnancy outcome in women with bad obstetric history and recurrent fetal loss due to thrombophilia: effect of unfractionated heparin and lowmolecular weight heparin. Clin Appl Thromb Hemost. 2008;14(2):174-9. [PubMed]
Glueck CJ, Wang P, Fontaine RN, Sieve-Smith L, Tracy T, Moore SK. Plasminogen activator inhibittor activity: an independent risk factor for the high miscarriage rate during pregnancy in women with polycystic ovary syndrome. Metabolism. 1999;48 (12):1589-95. [PubMed]
Glueck CJ, Awadalla SG, Phillips H, Cameron D, Wang P, Fontaine RN. Polycystic ovary syndrome, infertility, familial thrombophilia, familial hypofibrinolysis, recurrent loss of in vitro fertilized embryos, and miscarriage. Fertil Steril. 2000;74(2): 394-7. [PubMed]
Glueck CJ, Iyengar S, Goldenberg N, Smith LS, Wang P. Idiopathic intracranial hypertension: associations with coagulation disorders and polycysticovary syndrome. J Lab Clin Med. 2003;142(1):35-45. [PubMed]
Glueck CJ, Sieve L, Zhu B, Wang P. Plasminogen activator inhibitor activity, 4G5G polymorphism of the plasminogen activator inhibitor 1 gene, and first-trimester miscarriage in women with polycystic ovary syndrome. Metabolism. 2006;55(3): 345-52. [PubMed]
Atiomo WU, Condon J, Adekanmi O, Friend J, Wilkin TJ, Prentice AG. Are women with polycystic ovary syndrome resistant to activated protein C? Fertil Steril. 2000;74(6):1229-32. [PubMed]
Glueck CJ, Aregawi D, Goldenberg N, Golnik KC, Sieve L, Wang P. Idiopathic intracranial hypertension, polycystic-ovary syndrome, and thrombophilia. J Lab Clin Med. 2005;145(2):72-82. [PubMed]
Brenner B. Inherited thrombophilia and pregnancy loss. Thromb Haemost. 1999;82(2):634-40. [PubMed]
Rosendaal FR. Venous thrombosis: a multicausal disease. Lancet. 1999;353(9159):1167-73. [PubMed]
Tal J, Schliamser LM, Leibovitz Z, Ohel G, Attias D. A possible role for activated protein C resistance in patients with first and second trimester pregnancy failure. Hum Reprod. 1999;14(6):1624-7. [PubMed]
Brenner B, Mandel H, Lanir N, Younis J, Rothbart H, Ohel G, et al. Activated protein C resistance can be associated with recurrent fetal loss. Br J Haematol. 1997;97(3):551-4. [PubMed]
Atiomo WU, Fox R, Condon JE, Shaw S, Friend J, Prentice AG, et al. Raised plasminogen activator inhibitor-1 (PAI-1) is not an independent risk factor in the polycystic ovary syndrome (PCOS). Clin Endocrinol (Oxf). 2000;52(4):487-92. [PubMed]
Sohrabvand F, Lankarani M, Golestan B, Haghollahi F, Asgarpoor L, Badamchi Z, et al. [Serum homocysteine levels in PCOS patients versus healthy women]. J Reprod Infertil. 2009;9 (4):334-41. Persian. [Abstract]