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Reflections on the management of reproductive failure in the antiphospholipid syndrome—the clinician’s perspective

Institut Clínic of Gynaecology, Obstetrics and Neonatology, Catalonia, Spain; Institut Clínic of Gynaecology and Obstetrics, Hospital Clínic C/Casanova 143, 08036-Barcelona, Catalonia, Spain.; jbalasch{at}medicina.ub.es

R Cervera

Department of Autoimmune Diseases, Institut Clõánic of Infections and Immunology, Faculty of Medicine, University of Barcelona, Hospital Clõánic-Institut d0Investigacions Biome`diques August Pi i Sunyer, Barcelona,Catalonia, Spain

It is well known that women with systemic lupus erythematosus (SLE) who have antiphospholipid antibodies (aPL) are at increased risk for pregnancy loss. Additionally, other reproductive processes, such as unexplained infertility and implantation failure after in vitro fertilization and embryo transfer may be affected by aPL. Thus, clinical manifestations of the so-called ‘gynaecoobstetrical antiphospholipid syndrome’ have been expanded into the concept of the ‘reproductive autoimmune failure syndrome’. However, this is still a matter of debate with no general agreement with respect to both pathophysiological signi" cance of the presence of aPL and patient management. This article analyses a number of controversies in the management of reproductive failure potentially associated with aPL in order to help clinicians dealing with such condition in daily clinical practice.

Key Words: anticoagulation • antiphospholipid antibodies • aspirin • infertility • pregnancy loss • reproductive failure

Lupus, Vol. 11, No. 8, 467-477 (2002)
DOI: 10.1191/0961203302lu237ra


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				R Cervera and J Balasch The management of pregnant patients with antiphospholipid syndrome Lupus, September 1, 2004; 13(9): 683 - 687. [Abstract] [PDF]