If Russians love something, they do it with all their might, however little there may be…
One of the recent "love objects" of both doctors and patients is D-Dimer. We monitor it, build charts, control it at different laboratories, write posts in social networks and, most amazingly, draw absolutely obvious conclusions about the results of an IVF cycle on the basis of D-dimer concentration. The name is indeed stirring (almost as stirring as antiphospholipid syndrome), but that is all there is to it.
D-dimer is a product of fibrin decomposition, a small protein fragment present in blood after the breakdown of a blood clot (fibrinolysis). This is a citation from Wikipedia. The key word here is AFTER the breakdown of a blood clot. This parameter has its own place in clinical practice: first and foremost, it helps to rule out thromboembolia as well as to diagnose the DIC syndrome. Yet it is not meant to be used for Clexane or Fraxiparine dose adjustment. And by no means - for the assessment of protocol efficacy.
I suggest that we do not even start discussing immune infertility, since there is in fact no such diagnosis. Hence there will be no immunoglobulin drip bulbs, no glucocorticosteroid or lymphocyte therapy and surely no donor programmes for the treatment of this "pseudoproblem".