{"id":118,"title":"Recurrent venous thromboembolism despite natural cycle frozen embryo transfer in a woman with a history of pregnancy-related venous thromboembolism: A case report","title_zh":"自然周期冻融胚胎移植后仍复发静脉血栓栓塞：一例妊娠相关血栓史患者的病例报告","url":"https://pubmed.ncbi.nlm.nih.gov/42969006","doi":"10.20407/fmj.2026-002","pmid":"42969006","journal":"Fujita Med J","kind":"paper","lang":"en","published_at":"2026-09-25T00:00:00+00:00","fetched_at":"2026-11-08T03:43:53+00:00","authors":["Sato Y","Nishio E","Oikawa S","Odake S","Ishikawa M","Sakakibara E","Kotani K","Yoshizawa H","Miyamura H","Nishizawa H","Kisu I"],"primary_topic":"art-clinical","topics":[{"slug":"art-clinical","score":5.0,"hits":["frozen embryo transfer","in vitro fertilization"]}],"topic_score":5.0,"preference_score":5.0,"preference_labels":["可转化到 ART 实验室的发现"],"llm_score":60.0,"final_score":65.0,"score_dims":{"novelty":55,"rigor":30,"impact":45,"relevance":82,"translation":55},"recommend_reason":"该病例提示，对既往有妊娠相关血栓史的患者，自然周期冻融胚胎移植并不能免除复发风险，支持临床在ART妊娠早期即加强监测与抗凝；但证据为单个病例，仅可作临床提醒而非改变实践的依据。","keywords":["静脉血栓栓塞","冻融胚胎移植","自然周期","抗凝治疗","下腔静脉滤器","病例报告"],"selected":1,"story_id":429,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"本文报告一例33岁女性，首次自然妊娠晚期出现深静脉血栓，但未检出易栓症。为规避外源性雌激素暴露、降低血栓风险，第二次妊娠采用自然周期冻融胚胎移植，但她在妊娠8周时仍复发静脉血栓栓塞。随后启动抗凝治疗；因血栓持续存在且合并分娩相关风险，孕晚期置入下腔静脉滤器，最终经剖宫产分娩，产后血栓消退后取出滤器。作者指出，自然周期冻融胚胎移植虽较激素替代周期可能降低血栓风险，但不能消除有妊娠相关血栓史者的复发风险，早期抗凝与围产期包括选择性使用下腔静脉滤器的管理至关重要。","summary":"Pregnancy-associated venous thromboembolism (VTE) is a major cause of maternal morbidity and mortality. Pregnancies achieved by in vitro fertilization carry an increased risk of VTE, particularly during early gestation. A 33-year-old woman developed deep vein thrombosis during late pregnancy in her first spontaneous conception despite no identifiable thrombophilia. During a subsequent pregnancy achieved by natural cycle frozen embryo transfer, which was selected to avoid exogenous estrogen exposure and potentially reduce the thrombotic risk compared with hormone replacement cycles, she developed recurrent VTE at 8 weeks of gestation. Anticoagulation therapy was initiated, and an inferior vena cava (IVC) filter was placed in late pregnancy because of persistent thrombus and delivery-related risk. A cesarean section was successfully performed, and the IVC filter was removed postpartum after regression of the thrombus. Although natural cycle frozen embryo transfer may reduce the thrombotic risk compared with hormone replacement cycles, it does not eliminate the risk of recurrent VTE in women with a history of pregnancy-associated thrombosis. Early initiation of anticoagulation and careful peripartum management, including selective use of IVC filters, are essential in high-risk patients.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}