{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T10:04:00Z","timestamp":1771063440401,"version":"3.50.1"},"reference-count":148,"publisher":"Georg Thieme Verlag KG","issue":"01\/02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Reprod Med"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Alongside an interplay of a multitude of factors, attainment of a favorable pregnancy outcome is predicated on successful implantation, which in itself is a complex process anchored by balanced interchange with the hemostatic system. Among other etiologies, failure of implantation can result in infertility, and lead affected couples to consider assisted reproductive technology (ART) in an effort to fulfill their desire for procreation. Given the critical role of the hemostatic system in the process of implantation, documentation of a hypercoagulable state during controlled ovarian stimulation in the context of in vitro fertilization, as well as the potential association of its derangement in the setting of thrombophilia, with infertility, ART, ovarian hyperstimulation syndrome, and failure of implantation are explored. Additionally, current evidence addressing the relationship between ART and thromboembolism is examined, as is the role of therapy with heparin and aspirin to decrease thrombotic risk and improve ART-related pregnancy outcomes. Evidence-based recommendations from relevant professional societies are summarized.<\/jats:p>","DOI":"10.1055\/s-0041-1729763","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T23:32:04Z","timestamp":1621294324000},"page":"034-061","source":"Crossref","is-referenced-by-count":4,"title":["The Pathophysiology of Hypercoagulability and Infertility"],"prefix":"10.1055","volume":"39","author":[{"given":"Ann Kinga","family":"Malinowski","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Sinai Health System, Toronto, Canada"},{"name":"Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada"},{"name":"Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,5,17]]},"reference":[{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"545","DOI":"10.2217\/WHE.11.61","article-title":"Fertility, infertility and thrombophilia","volume":"7","author":"A Kuperman","year":"2011","journal-title":"Womens Health (Lond)"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/j.1600-0897.2012.01156.x","article-title":"Inherited thrombophilia and IVF failure: the impact of coagulation disorders on implantation process","volume":"68","author":"P Ivanov","year":"2012","journal-title":"Am J Reprod Immunol"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1055\/s-2006-958469","article-title":"The role of decidualization in regulating endometrial hemostasis during the menstrual cycle, gestation, and in pathological states","volume":"33","author":"C J Lockwood","year":"2007","journal-title":"Semin Thromb Hemost"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s12959-017-0131-7","article-title":"Impact of blood hypercoagulability on in vitro fertilization outcomes: a prospective longitudinal observational study","volume":"15","author":"G T Gerotziafas","year":"2017","journal-title":"Thromb J"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.thromres.2009.06.013","article-title":"Tissue factor and the endometrium: from physiology to pathology","volume":"124","author":"G Krikun","year":"2009","journal-title":"Thromb Res"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1093\/humupd\/8.4.333","article-title":"Conception to ongoing pregnancy: the \u2018black box\u2019 of early pregnancy loss","volume":"8","author":"N S Macklon","year":"2002","journal-title":"Hum Reprod Update"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.fertnstert.2019.11.025","article-title":"Definitions of infertility and recurrent pregnancy loss: a committee opinion","volume":"113","author":"Practice Committee of the American Society for Reproductive Medicine. 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