Should patients receive thrombophilia testing in the setting of a provoked VTE secondary to hormonal therapy/OCPs?

Given that oral contraceptives are considered a provoking event (Ortel et al., PMID 33007077), ASH Choosing Wisely guidelines recommend against thrombophilia testing since the recommended duration of anticoagulation is only 3 months. (Hicks et al., PMID 24307720 & Hicks et al., PMID 25472968).

Thrombophilia associated with oral contraceptives is often the event that reveals an underlying thrombophilia, particularly Factor V Leiden. The most common population are young women who will be facing future potential thrombophilic risk, particularly pregnancy. It is more an issue for the future rather than one which drives the length of anticoagulation.