The prevalance of thrombophilia among the patient; who had repeated intrauterine insemination for more than 3 cycles or who have UI for more than 5 years and among fertil women.

Infertility, that affects an estimated 10 to 20% of populatin of reproductive age in our country, is defined by the failure to conceive after 12 months of unprotected intercourse. Although it has many known causes, some couples are stil classified as having unexplained infertility (UI) because the underlying mechanism(s) is never found. The first approaches to overcome infertility include stimulation of ovulation with medications and artificial insemination. More invasive techniques requiring the use of assisted reproductive tecniques include in vitro fertilization and intracytoplasmic sperm injection. The estimate of the likelihood of a live birth per embryotransfer procedure with the use of assisted reproductive techniques is approximately 30%. Failed implantation is a major limiting factor in assisted reproduction.The mechanisms responsible for the 70% rate of failure of embriyo implantatin after assisted reproductive tecniques are largely unknown, and involve unsuccesful implantation and plascentation. It has been hypothesized that hypercoagulability in the mother due to the presence of thrombophilia abnormalities, leading to an impairment of the uteroplacental circulation, is among the possible causes of failure of embryo implantation.The purpose of this study was to evaluate the prevalance of thrombophilia among the patient; who had repeated intrauterine insemination for more than 3 cycles or who have UI for more than 5 years and among fertil women.A diagnosis of unexplained infertility is assigned to couples with normal results of standard infertility work-up. Than the study group was comprised of 25 women who had repeated intrauterine insemination for UI for more than 3 cycles (Group I) and 25 women who have UI for more than 5 years (Group II). The control group was comprised of 40 women who has least one live and healty child (Group III). All women were tested for the presence of inhereted (factor V Leiden mutation, prothrombin mutation, methylenetetrahydrofolate reductase (MTHFR) mutation and deficiencies in protein S and C and antithrombin III) or acquired (lupus anticoagulant and anticardiolipins) thrombophilic factors.In our study we found that least one thrombophilic factor prevalance was 88% in group I, 84% in group II and 55% in group III. This invention was statisticaly significant (P=0,005). A statisticaly significant increase in the prevalance of antithrombin III deficiency, combined thrombophilia, protein S deficiency, at least one inherited thrombophilic factor positive patient was found in study group (group I and group II),too. However, when the groups compared with regard to factor V Leiden mutation, prothrombin mutation, methylenetetrahydrofolate reductase (MTHFR) mutation and deficiency in protein C, lupus anticoagulant and anticardiolipins there was no statisticaly significant invention.As a result, thrombophilia is one of the reason for implantation failure. The prevalance of thrombophilia is significantly higher in women who had repeated intrauterine insemination for UI for more than 3 cycles and who have UI for more than 5 years unexplained infertility than fertil women. Before refered to assisted reproductive tecniques that is an invasive, psychologic traumatic treatment modality, the patient should be screened for thrombophilia. We thought that when the patient has a positive thrombophili marker if we start low-molecular-weight heparin before assisted reproductive tecniques the implantation rate wil be significantly increased.