Evaluation of Thrombophilic Factors in 230 Iranian Patients Affected with Recurrent Spontaneous Abortion

Background: One of the most common complications of re-production is RSA (recurrent spontaneous abortion). Based on previous researches, genetic abnormalities are one of the most common causes of RSA. It has been confirmed by many studies that there is a relationship between inherited thrombophilia and miscarriage and other adverse pregnancy outcomes. Throm-bophilia can be congenital or acquired. The most important types of congenital thrombophilia are those that arise as a re-sult of over activity of coagulation factors and associated with variation in additional genes including F2, F5, F5R2, MTHFR (Methylenetetrahydrofolatereductase), F13, FGB (Fibrinogen-Beta) and EPCR (Endothelial protein C receptor).Materials and Methods: In this study, we have investigated some important polymorphisms (F5 Leiden (G1691A), F5R2 (4070A> G or H1299R), F2 prothrombin (G20210A), F13 (V34L), FGB (455G> A), MTHFR (C677T and A1298C) and EPCR (4600A> G and 4678C> G)) using PCR-Sequencing method, in 230 patients with at least two idiopathic spontane-ous abortions.Results: According to our results, MTHFR and EPCR are two of the most important factors that have the most associa-tion with RSA. In MTHFR (A1298C) the frequency of geno-types AA, AC and CC in controls group were respectively 67%, 28.5% and 4.5% and in samples group were respectively 38.3%, 49.5% and 12.5%. In MTHFR (C677T) the frequency of genotypes CC, CT and TT in controls group were respective-ly 63.5%, 31% and 5.5% and in samples group were respective-ly 72%, 37% and 15%. In EPCR (4600A> G) the frequency of genotypes AA, AG and GG in controls group were respectively 89%, 10.3% and 0.7% and in samples group were respectively 60.5%, 34.5% and 5%. In EPCR (4678C> G) the frequency of genotypes CC, CG and GG in controls group were respectively 27.5%, 56% and 16.5% and in samples group were respectively 15%, 63% and 22%.Conclusion: There are many studies that these polymorphisms are responsible for increasing the risk of eradication of recur-rent abortions, while there are other reports that eliminate the association between these polymorphisms and recurrence. This difference can be due to differences in the criteria for choosing patients and the control group. The present results of this study confirm the association between RSA and investigated variants in FV Leiden, F2, FGB, MTHFR, and EPCR, while we did not find this association for variant in F5R213. In addition, the vari-ant in F13 seem to be a protective factor against RSA.

Keywords:

RSA , Thrombophilic , MTHFR , EPCR ,