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Debido al riesgo trombótico, y a sus implicaciones en la fertilidad, el síndrome antifosfolipídico (SAF) conlleva consideraciones particulares respecto a cualquier tipo de terapia hormonal y a la gestación. En el presente artículo, se procede a revisar ampliamente todos estos aspectos. Se desglosa lo referente a anticoncepción, terapia hormonal sustitutiva y moduladores selectivos de los receptores de estrógenos en el SAF. Se revisa la fertilización in vitro/transferencia embrionaria y la inducción ovárica en estas pacientes. Por último, se detallan las posibles complicaciones fetales y maternas durante la gestación, y basándose en la bibliografía, se indica una posible guía para el manejo del embarazo en mujeres con SAF.
Palabras clave:
Síndrome antifosfolipídico
Anticoncepción
Terapia hormonal
Embarazo
Fertilidad
Antiphospholipid syndrome (APS) carries a risk of thrombosis and infertility. Consequently the use of any type of hormone therapy and pregnancy in APS requires special considerations. The present article provides a broad review of all these issues. The use of contraception, hormone replacement therapy and selective estrogen receptor modulators in APS are described. In vitro fertilization/embryo transfer and ovarian induction in these patients are reviewed. Lastly, the possible fetal and maternal complications that can occur during pregnancy are described and, based on the literature, recommendations for the management of pregnancy in women with APS are provided.
Key words:
Antiphospholipid syndrome
Contraception
Hormone therapy
Pregnancy
Fertility
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