Читать книгу Assisted Reproduction Techniques - Группа авторов - Страница 81

1 Q1 If I am at “high risk” of venous thromboembolism (VTE) during IVF, what is the treatment that will be recommended to me? A1. Low‐molecular weight heparin administered subcutaneously is the treatment of choice for VTE prophylaxis. The dose is calculated according to body weight and is taken daily. An example of a dosing regimen using a commonly used LMWH is shown in Table 8.2.Table 8.2 Enoxaparin dosing regimen for VTE prophylaxis [8].WeightEnoxaparin<50 kg20 mg daily50–90 kg40 mg daily91–130 kg60 mg daily^*131–170 kg80 mg daily^*>170kg0.6 mg/ kg/ day^** can be given in 2 divided doses

2  Q2. When will I be expected to commence this treatment? A2. This will depend on the local protocol of your fertility unit. Treatment can commence soon after egg collection or even earlier during the stimulation process. If it is commenced prior to egg collection, it should be withheld for 24 hours before the procedure.

3  Q3 If I develop deep vein thrombosis during my IVF cycle, how will it be treated? A3. It will be treated with low‐molecular weight heparin administered subcutaneously, but at a higher dose than for prophylaxis. Again, it will be calculated according to body weight.

4  Q4 What are the risks of this treatment? A4. Administration of low‐molecular weight heparin is largely safe. It carries a small risk of heparin induced thrombocytopenia (low platelets) or heparin induced osteoporosis (bone thinning). Patients can also develop allergic skin reactions, but again this risk is very small [8].