Don’t routinely order thrombophilia testing on patients undergoing a routine infertility evaluation.
|Rationale and Comments:||There is no indication to order these tests, and there is no benefit to be derived in obtaining them in someone that does not have any history of bleeding or abnormal clotting and in the absence of any family history. This testing is not a part of the infertility workup. Furthermore, the testing is costly, and there are risks associated with the proposed treatments, which would also not be indicated in this routine population.|
|References:||• Lockwood C, Wendel G; Committee on Practice Bulletins—Obstetrics. Practice bulletin no. 124: inherited thrombophilias in pregnancy. Obstet Gynecol. 2011 Sept;118(3):730-40.
• Casadei L, Puca F, Privitera L, Zamaro V, Emidi E. Inherited thrombophilia in infertile women: implication in unexplained infertility. Fertil Steril. 2010 Jul;94(2):755-7.
• The Practice Committee of the American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril. 2012 Aug;98:302-7.
• Baglin T, Gray E, Greaves M, Hunt B, Keeling D, Machin S, Mackie I, Makris M, Nokes T, Perry D, Talt RC, Walker I, Watson H. Clinical guidelines for testing for heritable thrombophilia. Br J Haematol. 2010;149:209-20.