[Inherited thrombophilic factors in women with secondary infertility].

Because of the presence of additional confounding factors, such as cervical incompetence or uterine infections, the impact of inherited thrombophilia in women with second infertility has been hard to assess. The evaluation of the significance of the most common inherited thrombophilic factors - Factor V Leiden (FVL), prothrombin gene mutation 20210 G > A (FII), polymorphism (PL) 677 C > T in MTHFR, PL A1/A2 in platelet glycoprotein IIb/IIIa and PAL-1 PL 4G/5G in 35 women with two or more secondary (who have given birth to at least one child) recurrent pregnancy loss (RPL) before 14 weeks of gestation compared to 70 healthy women with no history of RPL and at least one uncomplicated full-term pregnancy, has been performed. Eight out of 35 women with secondary RPL (25.7%) and 6 out of 70 controls (8.6%) have had FVL or FII 20210 G > A (OR: 3.7, 95% CI: 1.05-13.2, p = 0.038). Five (14.3%) women with secondary infertility were carriers for FVL and four (11.4%) for FII 20210 G > A, corresponding to four (5.7%) and two (2.9%) of the women in the control group. The carrier status for MTHFR 677 C > T (TT genotype), PL A1/A2 and PL 4G/5G (4G/4G genotype) was as follows: 11.4%, 28% and 30.8% in patients and 14.3%, 17.1% and 24.3% in controls without significant difference between the groups. Despite of the presence of background factors, an appreciable role of inherited thrombophilia in secondary RPL was established, which enforces thrombophilia testing and management of women with second infertility as well as women with primary RPL.