The Effect of In Vitro Fertilization on Coagulation Parameters as Measured by Thromboelastogram

Study Overview
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Brief Summary
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Since its introduction in 1978, over 3.75 million babies have been born using in vitro fertilization (IVF). Maturing ovarian follicles lead to a large rise in estrogen to supra-physiological levels . This increase in estrogen has been shown to cause a hypercoagulable state, leading at times to arterial and venous thrombosis.(Thromboelastogram (TEG) is a point of care whole blood hemostatsis analyzer mimicking in vivo conditions and measuring visco elastic properties of the clot. The TEG shows effect of most of the components of hemostatsis: coagulation factors, fibrinogen, platelets and fibrinolysis. Components of TEG include R, reflecting coagulation factor cascade, alpha angle and K measurements reflecting fibrin function, MA reflecting mostly thrombocyte function, coagulation index (CI) measuring global hemostatic statis and LY30 measuring fibrinolysis. In this study the investigators would like to measure serum estrogen levels and (TEG) in parturients at the beginning and conclusion of an IVF simulation cycle and evaluate how it's influnence on coagulation parameters, and wheather or not a large sample size will effect primary outcomes. Secondarily the investigators would like to see if estrogen levels are predictors of coagulation parameters and see if age influences TEG parameters

Conditions
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Fertilization in Vitro and Blood Coagulation Factors

Intervention / Treatment
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* Other: Blood coagulation anyalsis by Thromboelastogram


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Parturients above 18 undergoing in-vitro fertilization at rabin medical center, with the ability to comply with the study requriments. Exclusion Criteria: Parturients were excluded if they had; hypertension, diabetes, anticoagulation therapy or any platelet disorder, or were not able to comply with study requirments.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 43 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Women under IVF stimulation at the begining and end<br>Coagulation parameters will be measured for all parturients at the beginning and conclusion of an IVF simulation cycle with the use of thromboelastogram | Other: Blood coagulation anyalsis by Thromboelastogram<br>* Two blood tests will be taken during routine tests from all parturient s undergoing IVF treatment before starting gonadotropins treatment (the first few days of menstruation) and at the height of hormone therapy prior to egg retrieval Coagulation parameters will be measured by the use of Thromboelastogram<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measurement of fibrin function in parturients undergoing IVF by Thromboelastogram |  | one year | 
| Measurement of thrombocyte function in parturients undergoing IVF by Thromboelastogram |  | one year | 
| Measurement of global hemostatic statis in parturients undergoing IVF by Thromboelastogram |  | one year | 
| Measurement of fibrinolysisin parturients undergoing IVF by Thromboelastogram |  | one year |