METHOD FOR CORRECTION OF HAEMOSTASIS DISORDERS IN FEMALES ACCOMPANYING EXTRACORPOREAL FERTILIZATION Russian patent published in 2020 - IPC A61B17/42 A61K31/727 A61P7/02 

FIELD: medicine; obstetrics; hematology.

SUBSTANCE: prescribing an anticoagulant preparation or a fibrinolysis inhibitor for women performing an IVF procedure. All women undergoing VRT cycle 3–4 days before embryo transfer (in case of the frozen embryos transfer protocol) or 2–3 days after the oocyte puncture (if the superovulation stimulation protocol is being performed), the haemostasis plasma link is examined by thrombodynamics, estimation of D-dimer level, time of XIIa-dependent fibrinolysis. If observing a pathological increase in the clot formation (and/or initial) rate, as well as a high density of the clot and/or spontaneous clots and if spontaneous clots are detected during 30 minutes of observation, Thrombodynamics (TD) test involves therapy with low-molecular heparins (LMWH) in a preventive dose [Application of thrombodynamics test for evaluation of haemostasis system state: educational-methodical recommendations. Ed. Shulutko A.M. Moscow. 2015]. Further, the state of plasma haemostasis is monitored by TD, D-dimer and XIIa-dependent fibrinolysis at 2, 8, 8–9 days after embryo transfer. If observing an increase in the stationary speed of more than 35 mcm/min or initial velocity of more than 60 mcm/min and/or presence of spontaneous clots within 30 minutes of observation, a preventive dose of low-molecular heparin is adjusted upwards. In case of low clot density by thrombodynamics (less than 25000 opt units), in the absence of increase in the rate of the stationary and/or initial speed above the reference values, the time XIIa-dependent fibrinolysis is evaluated. If patient is 5 minutes or less, the patient is prescribed an orally inhibitory fibrinolysis agent, for period of 3 days or more for the purpose of moderate suppression of hyperfibrinolysis under the control of the same laboratory tests. In case of complaints of idiopathic headache, or elongation of XIIa-dependent fibrinolysis more than 12 min, or increasing the stationary and/or initial rate of clot formation above the reference values, the fibrinolysis inhibitor is canceled and low-molecular heparin is administered in a preventive dose if observing pathological hypercoagulation according to control laboratory tests. Thereafter, the values are monitored every 4 weeks, followed by correcting the dose of low-molecular heparin if necessary.

EFFECT: method allows to increase the pregnancy rate after the IVF protocol and ensure successful gestation, adequate correction of hemostasis disorders ensured by individual laboratory monitoring, simplified decision making on the strategy of prescribing preparations (anticoagulants or antifibrinolytics) using the results of three tests assessing the state of the hemostasis system.

1 cl, 2 ex