Fertil Steril. 2007 Jun 18

Factor V Leiden mutation: a treatable etiology for sporadic and recurrent pregnancy loss.
Glueck CJ, Gogenini S, Munjal J, Tracy T, Pranikoff J, Wang P.

Cholesterol Center, Jewish Hospital, Cincinnati, Ohio.

Objectives:

We hypothesized that the thrombophilic G1691A factor V Leiden (FVL) gene mutation was a common, significant, and treatable cause of sporadic and recurrent pregnancy loss (RPL).

Design:

We compared the Frequency of the FVL mutation in 141 women with >/=1 pregnancy and 1 sporadic pregnancy loss (308 live births, 141 pregnancy losses), 44 women with >/=1 pregnancy and >/=3 pregnancy losses (105 live births, 180 pregnancy losses), and 638 women with >/=1 live birth pregnancy and 0 pregnancy loss (1553 live births).

Setting:

Outpatient Clinical Research Center.

Patients:

A total of 823 caucasian women with consecutive measures of the FVL mutation.

Main Outcome Measures:

We used polymerase chain reaction techniques to characterize the thrombophilic FVL G1691A gene mutation.

Results:

Of the 638 controls, 47 (7.4%) had FVL heterozygosity versus 16 heterozygous and 2 homozygous FVL cases (18/141, 12.8%) in 141 women with 1 sporadic pregnancy loss versus 9/44 RPL cases (20.5%, 8 heterozygous and 1 homozygous FVL). The FVL Frequency in cases with 1 sporadic pregnancy loss (18/141, 12.8%) did not differ from RPL cases (9/44, 20.45%).

Conclusions:

After unexplained sporadic pregnancy loss, as well as after RPL, to provide the option to prospectively optimize subsequent live birth outcomes with low-molecular-weight heparin thromboprophylaxis, we suggest that measurements be done of the FVL mutation, a treatable etiology for sporadic pregnancy loss as well as for RPL.

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