In Ivana’s case, there is a family predisposition to thrombotic risk. According to the most recent guidelines, also in this case specific tests are not recommended. The reasons are different, and certainly the gynecologist has explained them extensively to Ivana.
Compared to the most common blood chemistry tests (the classic blood test, for instance), specific tests for thrombophilia are highly complicated and varied, and have a high diagnostic error rate. Furthermore, they have little predictive value, and thus they are not recommended for routine use. Medically, this results in the risk of over-diagnosis and excessive medicalization, as well as unnecessary high costs. Experts in this matter believe that a negative result may be falsely reassuring, while a false positive may unnecessarily discourage the use of contraception. The gynecologist should evaluate each person on a case-by-case basis.