A retrospective analysis of fondaparinux versus enoxaparin treatment in women with infertility or pregnancy loss

Am J Reprod Immunol. 2009 Oct;62(4):253-60. doi: 10.1111/j.1600-0897.2009.00733.x. Epub 2009 Aug 24.

Abstract

Problem: We compared the pregnancy success rates and safety parameters of fondaparinux versus enoxaparin, combined with immunotherapy, in patients with a history of miscarriage and/or infertility and coagulant defects.

Method of study: A total of 127 pregnancies in 110 patients with a history of miscarriage and/or infertility were retrospectively evaluated. Of these, 29 pregnancies used fondaparinux 2.5 mg daily and 98 pregnancies used enoxaparin 30 mg twice daily.

Results: The pregnancy success rate was 59% (17/29; 95% CI, 41-75%) for patients receiving fondaparinux and 58% (57/98; 95% CI, 48-68%) for patients receiving enoxaparin. No difference was detected in birth weight (2.7 +/- 0.8 and 2.9 +/- 0.6 kg, respectively) or gestational age at delivery (37.3 +/- 2.2 and 37.7 +/- 2.1 weeks, respectively). No birth defects, severe bleeding-related complications, or serious allergic reactions were observed.

Conclusion: In patients with a history of miscarriage, infertility, and coagulant defects receiving immunotherapy, fondaparinux resulted in successful pregnancy outcomes comparable with enoxaparin therapy. Although no difference in outcome was observed in our analysis, a much larger study is required to achieve statistical power.

Publication types

  • Comparative Study

MeSH terms

  • Abortion, Spontaneous / diagnosis
  • Abortion, Spontaneous / immunology
  • Abortion, Spontaneous / physiopathology
  • Abortion, Spontaneous / therapy*
  • Adult
  • Combined Modality Therapy
  • Enoxaparin / adverse effects
  • Enoxaparin / therapeutic use*
  • Female
  • Fondaparinux
  • Humans
  • Immunotherapy
  • Infertility, Female / diagnosis
  • Infertility, Female / immunology
  • Infertility, Female / physiopathology
  • Infertility, Female / therapy*
  • Polysaccharides / adverse effects
  • Polysaccharides / therapeutic use*
  • Pregnancy
  • Pregnancy Outcome
  • Retrospective Studies

Substances

  • Enoxaparin
  • Polysaccharides
  • Fondaparinux