Reproductive failure (RF) is the inability to conceive or to carry a pregnancy to term, and its prevalence is not negligible. Pregnancy is a prothrombotic condition, which can be abnormally exaggerated in women with thrombophilia. Antiphospholipid syndrome is a cause of RF and effectively managed with heparin and aspirin. However, there are yet insufficient data in patients with RF and inherited thrombophilia. This review focuses on the significance of inherited thrombophilia and RF and the role of anticoagulants in pregnancy outcomes. A few randomized case‐control studies have investigated the effect of anticoagulation in RF with thrombophilia, and the results are yet debatable. Some inherited thrombophilia including mutations of factor V Leiden, prothrombin, and methylenetetrahydrofolate reductase and protein S deficiency are associated with RF and/or late pregnancy complications. There are several implications which influence the diagnosis and treatment. First, there is a lack of studies revealing appropriate thrombophilia markers and its cutoff values for RF specifically. Second, some thrombophilia markers change with sex and age. Lastly, the study designs of previous studies are heterogeneous in selecting the thrombophilia markers and drugs. Further studies to find adequate thrombophilia markers of RF are warranted and eventually elucidate the subgroups beneficial to anticoagulation treatment.

中文翻译：

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生殖障碍女性的遗传性血栓形成倾向和抗凝治疗

生殖失败 (RF) 是无法怀孕或无法怀孕至足月，其患病率不容忽视。怀孕是一种血栓前状态，在患有血栓形成倾向的女性中可能会异常夸大。抗磷脂综合征是 RF 的一个原因，可以用肝素和阿司匹林有效控制。然而，关于 RF 和遗传性血栓形成倾向患者的数据尚不充分。本综述重点关注遗传性血栓形成倾向和 RF 的重要性以及抗凝剂在妊娠结局中的作用。一些随机病例对照研究调查了抗凝治疗对有血栓形成倾向的 RF 的影响，但结果仍有争议。一些遗传性血栓形成倾向，包括因子 V Leiden、凝血酶原、亚甲基四氢叶酸还原酶和蛋白 S 缺乏与 RF 和/或晚期妊娠并发症有关。有几个影响会影响诊断和治疗。首先，缺乏揭示适当的血栓形成倾向标志物及其针对 RF 的临界值的研究。其次，一些易血栓标志物随性别和年龄而变化。最后，以往研究的研究设计在选择易血栓标志物和药物方面存在异质性。需要进一步研究以找到足够的 RF 血栓形成倾向标志物，并最终阐明有利于抗凝治疗的亚组。缺乏揭示适当的血栓形成倾向标志物及其专门针对 RF 的临界值的研究。其次，一些易血栓标志物随性别和年龄而变化。最后，以往研究的研究设计在选择易血栓标志物和药物方面存在异质性。需要进一步研究以找到足够的 RF 血栓形成倾向标志物，并最终阐明有利于抗凝治疗的亚组。缺乏揭示适当的血栓形成倾向标志物及其针对 RF 的临界值的研究。其次，一些易血栓标志物随性别和年龄而变化。最后，以往研究的研究设计在选择易血栓标志物和药物方面存在异质性。需要进一步研究以找到足够的 RF 血栓形成倾向标志物，并最终阐明有利于抗凝治疗的亚组。