Abstract
Thrombotic complications represent uncommon but potentially life-threatening adverse events associated with assisted reproductive technologies (ARTs), particularly in the setting of controlled ovarian stimulation and ovarian hyperstimulation syndrome (OHSS). The relationship between thrombophilia, infertility, ovarian hyperstimulation syndrome (OHSS), and venous thromboembolism (VTE) remains complex and only partially understood. While antiphospholipid syndrome is a well-established acquired thrombophilic disorder associated with recurrent pregnancy loss, the association between common inherited thrombophilias and recurrent pregnancy loss is less consistent, and their contribution to primary infertility and implantation failure remains uncertain. Conversely, severe OHSS is consistently recognized as the principal treatment-related determinant of thrombotic events during IVF because of profound endothelial activation, hemoconcentration, and hypercoagulability. This narrative review summarizes the current evidence regarding the epidemiology, pathophysiology, and clinical presentation of thrombotic complications associated with assisted reproductive technologies, including deep vein thrombosis, pulmonary embolism, cerebral venous thrombosis, upper-extremity thrombosis, splanchnic vein thrombosis, and arterial thrombotic events. Current recommendations for thromboprophylaxis, diagnostic strategies, and therapeutic management are critically discussed, with particular attention to individualized risk assessment and the role of low-molecular-weight heparin in high-risk patients. Although routine thromboprophylaxis is not recommended for all women undergoing in vitro fertilization (IVF), careful evaluation of patient-specific thrombotic risk factors remains essential. Future prospective studies are needed to improve risk prediction, optimize preventive strategies, and establish evidence-based recommendations for women undergoing assisted reproduction.