Anticoagulants and fertility hematology

What are anticoagulants?

Simply put, they are those drugs that decrease blood clotting. In other words, they are used to prevent or treat the formation of clots, that is, thrombosis. There are two types: those that are injected, such as Heparin, which are used in the acute moment, at the time of diagnosis. And those taken orally, which are intended for longer treatments. There are three groups of patients who will need anticoagulants. Those who need to treat or prevent thrombosis in the veins of the legs or in the lung, those with cardiovascular diseases, especially an important group with atrial fibrillation who also need protection against embolisms, and the third group are those who have undergone heart surgery and have a heart valve.

New drugs have recently come out. Are they better than Cintron?

That’s a difficult question. For 50 years we have had Cintron, now we have three new drugs, Pradaxa, Xarelto and Eliquis. And they certainly have great advantages, but these advantages do not occur in all patients, there may even be disadvantages for some patients in particular. But we can give some clues. Patients who are carriers of heart valves should continue with Cintron because these drugs are ineffective in them. Patients who have been on Cintron for many years and who have been well controlled, who have not had any complications are not likely to benefit from the change. And also patients who have had problems with Cintron, who are poorly controlled or have had some complication are very likely to benefit from the change, always under the indication of a physician expert in anticoagulant treatment.

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What is self-management of anticoagulant therapy?

It is a system in which the patient taking Cintron has a small device and can test himself at home, he can test himself. He can even adjust the dose himself or under supervision. It has a great advantage over the usual treatment, which is that we can do the controls much more frequently, we can do them once a week instead of once a month, which is what you do when you go to the outpatient clinic or to a hospital. More frequent monitoring allows us to achieve better control, reduce complications and, without a doubt, in the long term it is the safest treatment for patients.

Are there hematological problems that affect fertility?

The subject of fertility is a delicate one. If we look at the female aspect, we know that multiple factors have an influence: age, the quality of the oocytes, of the eggs, endocrine and immunological factors, etc. We also know that there are a series of factors that affect fertility. We also know that there are a series of hematological factors, almost all related to thrombophilia, with the tendency to have thrombi, which can be accompanied by fertility problems. Basically repeated miscarriages and implantation failures. This has been seen because patients with recurrent thrombosis not only had thrombosis but also problems of this type. The advantage is that it has a good treatment. Therefore, if there is no other cause for repeated miscarriages or implantation problems, one of the issues to be studied is the hematological issue.