Human Reproduction Update Advance Access originally published online on August 12, 2008
Human Reproduction Update 2008 14(6):623-645; doi:10.1093/humupd/dmn031
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The potential role of heparin in assisted conception
1 Reproductive and Maternal Medicine, Division of Developmental Medicine, University of Glasgow, Glasgow Royal Infirmary, 10 Alexandra Parade, Glasgow G31 ER, UK 2 Hull York Medical School, University of York, Heslington, York YO10 5DD, UK
3 Correspondence address. Tel: +44-141-211-4705; Fax: +44-141-552-0873; E-mail: s.nelson{at}clinmed.gla.ac.uk
BACKGROUND: Heparan sulphates play key roles in conception and early pregnancy events. The role of heparin, a structural analogue, and its application to assisted conception, is largely unknown.
METHODS: Relevant studies were identified by searching PubMed 1966–November 2007 and Google Scholar without limitations. Sensitive search strategies were combined with relevant medical subject headings and text words.
RESULTS: The similarities of heparin and heparan, the haemostatic changes induced by ovarian stimulation and the risk of thrombosis, the contribution of thrombophilia to pregnancy and infertility outcomes, early embryo-maternal dialogue and how these various aspects of assisted conception may be modified by heparin are reviewed.
CONCLUSIONS: Heparin can alter the haemostatic response to controlled ovarian stimulation and modify the risk of thrombosis. It can also modulate many of the fundamental physiological processes required for blastocyst apposition, adherence and implantation and as well as trophoblast differentiation and invasion due to its similarities with heparan sulphates and has the potential to improve pregnancy rates and outcomes.
Key words: heparin / thrombosis / infertility / implantation / assisted conception
Received on January 7, 2008; revised March 27, 2008; accepted on April 17, 2008
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