Management of patients with antiphospholipid antibodies undergoing in vitro fertilization

Infertility affects 10-15% of all married couples of reproductive age in th e United States and results in substantial emotional distress and medical i nvestment. Though it is uncertain whether antiphospholipid syndrome (APS) i s a cause of infertility, inevitably there is a small proportion of women w ho have both APS and infertility. in turn, some of these patients are candi dates for ovulation induction, with or without assisted reproductive techno logies, such as in vitro fertilization and embryo transfer, in an attempt t o achieve successful pregnancy. The medications used for ovulation inducati on cause an increase in ovarian estrogen production beyond that typical of a normal menstrual cycle. Clinicians are appropriately concerned about the potential adverse effects of this estrogen surge on the clinical status of women with autoimmune disease. For APS, a primary concern would be that of thrombosis or embolism. (C) 2000 Academic Press.