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.