JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):35
Poster Presentation
29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263559

P-023. Association between hereditary and acquired thrombophilic factors in reduced ovarian reserve in young women

João Paolo Bilibio¹, Arivaldo Jose Conceição Meireles², Martina Cordoni¹, Ana Carolina Martinhago¹, Leticia Avi¹, Julia Orci Potter³, Panila Longhi Lorenzzoni¹

¹ FertiBC Centro de Reprodução Humana - Balneário Camboriú - SC - Brasil
² PRONATUS - Bélem - PA - Brasil
³ Universidade do Vale do Itajaí - UNIVALI - Itajaí - SC - Brasil

Objective: To assess the association between hereditary thrombophilic factors (Factor II mutation, Factor V Leiden mutation, MTHFR C677T and A1298C polymorphisms) and acquired thrombophilic factors (Protein C deficiency, Protein S deficiency, homocysteine, and Antithrombin III deficiency) with reduced ovarian reserve in women aged 18 to 35 years.
Methods: A cross-sectional, retrospective, descriptive study was conducted with 96 women aged 18 to 35 years, divided into two groups: low ovarian reserve (CFA <5) and normal ovarian reserve (CFA ≥5). Ovarian reserve was assessed by Antral Follicle Count (CFA), FSH, AMH, LH, and E2. Thrombophilic factors were evaluated by testing Factor II mutation, Factor V Leiden mutation, MTHFR C677T and A1298C polymorphisms, and Protein C, Protein S, homocysteine, and Antithrombin III deficiencies. Ethical approval was obtained from the Ethics Committee (CAAE number 83327218.9.0000.0018).
Results: The sample consisted of 40 women with low ovarian reserve and 51 women with normal ovarian reserve. Hereditary thrombophilic factors, such as Factor II mutation and MTHFR C677T and A1298C polymorphisms, were significantly associated with reduced ovarian reserve. Factor II mutation was observed in 76% of the low ovarian reserve group, with an odds ratio (OR) of 7.8 (CI 1.2-34.4, p=0.04). The MTHFR C677T polymorphism was found in 47.8% of the low reserve group, with an OR of 3.4 (CI 1.8-12.5, p=0.05), and the MTHFR A1298C polymorphism was observed in 25.2% of the low reserve group, with an OR of 5.7 (CI 1.2-31.0, p=0.04). No significant associations were found between acquired thrombophilic factors and reduced ovarian reserve.
Conclusion: Hereditary thrombophilic factors, such as Factor II mutation and MTHFR C677T and A1298C polymorphisms, are significantly associated with reduced ovarian reserve in young women. The presence of these polymorphisms increased the risk of ovarian reserve reduction by 7.8, 3.4, and 5.7 times, respectively. These findings suggest that hereditary thrombophilic factors may act as independent predictors of reduced ovarian reserve in young women, with clinical implications for fertility management. Although the exact mechanism is not fully understood, interference in ovarian microcirculation may be an underlying factor. Further studies are needed to better elucidate the biological mechanisms involved and to evaluate the clinical impact of these conditions on fertility and the management of women with reduced ovarian reserve.