• Karin Rova, Henrik Passmark, and Pelle G Lindqvist.
• Department of Fertility, Clintec, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
• Fertil. Steril. 2012 Jan 1;97(1):95-100.

ObjectiveTo determine the incidence and the increase in risk of venous thromboembolism (VTE) in relation to IVF and ovarian hyperstimulation syndrome (OHSS) in successful cycles.DesignCohort study.SettingPopulation based.Patient(S)All deliveries (n = 964,532) in Sweden during a 10-year period (1999-2008).Intervention(S)Comparison of VTEs among those with and without IVF. The National Birth Registry was cross-matched with both the National Discharge Registry and the National IVF Registry. Logistic regression analysis was used to determine odds ratios and 95% confidence intervals.Main Outcome Measure(S)Risk of first trimester VTE.Result(S)The incidence of first-trimester VTE in relation to IVF was 0.2%, representing a 10-fold increase as compared with the background population. The 6% to 7% of IVF pregnancies that were complicated by OHSS showed a 100-fold increased risk of VTE, as opposed to the fivefold increased risk seen in the absence of OHSS. The VTEs in conjunction with IVF were diagnosed at a mean gestational age of 62 days; there was no increased risk of VTE related to frozen embryo replacement cycles or IVF after the first trimester.Conclusion(S)Treating women with OHSS with low-molecular-weight heparin thromboprophylaxis during the first trimester and treating cases at high-risk for OHSS with frozen embryo replacement is likely to lower the risk of VTE.Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

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