Abstract

Objective: To find incidence of congenital thrombophilia in unexplained infertility versus fertile female population with intend to determine if thrombophilia is a possible cause and which type of thrombophilia is more prevalent in unexplained infertility. Methods: Study group (Group A) comprised of 40 infertile patients of age between 20 40 years in whom no cause of infertility was identified. The control group comprised of 40 healthy women with proven fertility, matched for age, with no history of thrombo-embolic events. Both the groups were tested for inherited thrombophilia included Protein C, Protein S, Anti-thrombin III, Activated Protein C Resistance, Homocysteine, factor V Leiden (PCR), Prothrombin G20210 G gene and M THFR (677c/T)gene mutation. Results: Overall 14 (35%) subjects in the unexplained infertility group, and 5 (12.5%) in the control group were detected with positive thrombophilic factor (p value-0.023). Out of 14 positive cases, 7/14(50%) had more than one factor (35% had 2 and 15% had 3 factors)thus 23 thrombophilia factors in 14 women in group 1 in comparision of onlt 7 in 5 in (2 with 2 factors)group2 (p=0.005). Out of 23, Protein S (10%) and Antithrombin III (10%) had the highest frequency followed by Homocysteine (7.5%), Protein C (7.5%), MTHFR gene mutation (7.5%), prothrombin 20210 (5%), Factor V Leiden (5%) and APCR (5%)in group1 Out of the 7 thrombophilia factors in controls, Factor V Leiden mutation and APCR had the highest frequency (5%) followed by Protein S, Protein C, and Homocysteine (2.5%). APCR and Factor V leiden were similar in both groups whereas Hyperhomocysteinaemia combined with MTHFR gene mutation was more in unexplained infertility andprothrombin gene was found only in unexplained infertility Conclusion: There is significant association of thrombophilia with unexplained infertility Hyperhomocystinaemia combined with MTHFR gene mutation and APCR with prothrombin gene mutation are more likely to be associated with unexplained infertility. Thrombophilia evaluation may be included along with other tests in evaluation of unexplained infertility.

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