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  • Title: Factor V Leiden mutation: a treatable etiology for sporadic and recurrent pregnancy loss.
    Author: Glueck CJ, Gogenini S, Munjal J, Tracy T, Pranikoff J, Wang P.
    Journal: Fertil Steril; 2008 Feb; 89(2):410-6. PubMed ID: 17582408.
    Abstract:
    OBJECTIVE: We hypothesized that the thrombophilic G1691A factor V Leiden (FVL) gene mutation was a common, significant, and treatable cause of sporadic and recurrent pregnancy loss (RPL). DESIGN: We compared the frequency of the FVL mutation in 141 women with >or=1 pregnancy and 1 sporadic pregnancy loss (308 live births, 141 pregnancy losses), 44 women with >or=1 pregnancy and >or=3 pregnancy losses (105 live births, 180 pregnancy losses), and 638 women with >or=1 live birth pregnancy and 0 pregnancy loss (1553 live births). SETTING: Outpatient Clinical Research Center. PATIENT(S): A total of 823 caucasian women with consecutive measures of the FVL mutation. MAIN OUTCOME MEASURE(S): We used polymerase chain reaction techniques to characterize the thrombophilic FVL G1691A gene mutation. RESULT(S): Of the 638 controls, 47 (7.4%) had FVL heterozygosity versus 16 heterozygous and 2 homozygous FVL cases (18/141, 12.8%) in 141 women with 1 sporadic pregnancy loss versus 9/44 RPL cases (20.5%, 8 heterozygous and 1 homozygous FVL). The FVL frequency in cases with 1 sporadic pregnancy loss (18/141, 12.8%) did not differ from RPL cases (9/44, 20.45%). CONCLUSION(S): After unexplained sporadic pregnancy loss, as well as after RPL, to provide the option to prospectively optimize subsequent live birth outcomes with low-molecular-weight heparin thromboprophylaxis, we suggest that measurements be done of the FVL mutation, a treatable etiology for sporadic pregnancy loss as well as for RPL.
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