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| Relationship between Pre-Thrombotic State Markers and Repeated Implantation Failure and Their Predictive Value in Patients Undergoing in Vitro Fertilization-Embryo Transfer |
| YUAN Yiwen, LI Min, SHEN Yuliang |
| Sixth Medical Centre, General Hospital of the People's Liberation Army, Beijing 100048, China |
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Abstract Objective: To explore relationship between pre-thrombolic state (PTS) markers and repeated implantation failure (RIF) in patients undergoing in vitro fertilization-embryo transfer (IVF-ET), and to analyze their predictive value in RIF. Methods: A retrospective analysis was performed on the clinical data of 118 patients (RIF group) with RIF and 110 patients (control group) undergoing IVF-ET for the first cycle in the hospital between June 2019 and March 2024. The peripheral venous blood was collected before embryo transfer to detect PTS markers [antithrombin III (AT-III), human prothrombin fragment 1+2 (F1+2), platelet α-granular membrane protein-140 (GMP-140), Von willebrand factor (vWF)]. The relationship between PTS markers and RIF was analyzed by Logistic regression analysis, and their predictive value for RIF was analyzed by receiver operating characteristic (ROC) curves. Results: There were no significant differences in infertility duration, infertility factors, BMI, gonadotropin (Gn) dosage, or Gn treatment duration between the RIF group and the control group (P>0.05). The RIF group had a significantly older age, fewer oocytes retrieved, and fewer high-quality embryos than the control group (P<0.05). Levels of prethrombotic state markers F1+2, GMP-140, and vWF were significantly higher in the RIF group, while AT-Ⅲ expression was significantly lower (P<0.05). Logistic regression analysis showed that a higher number of oocytes retrieved, more high-quality embryos, higher fertilization rate, and higher AT-Ⅲ expression were protective factors against RIF in IVF-ET patients. Age, as well as high expression of F1+2, GMP-140, and vWF, were risk factors for RIF. The combined detection of prethrombotic state markers F1+2, GMP-140, vWF, and AT-Ⅲ had an area under the ROC curve (AUC) of 0.817 for predicting RIF in IVF-ET patients, which was significantly higher than the AUC values of individual markers (0.722, 0.713, 0.730, and 0.726, respectively; P<0.05). Conclusion: Age, number of retrieved oocytes, number of high-quality embryos and PTS are all influencing factors of RIF in IVF-ET patients. F1+2, GMP-140, vWF and AT-III can predict the occurrence of RIF to a certain extent.
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2025, Vol. 31 
