Suggested treatment algorithm for ITP. *These are overall factors that go for or against splenectomy without distinguishing between TPO-RA and rituximab. †Based on recommendations to defer splenectomy for 1 year, if possible. ‡Alternative option is rituximab, and wait for 12 months before conception. §Anticipated poor compliance is also applicable to splenectomy, although post-splenectomy management (eg, repeat vaccination, management of febrile illness, and follow-up regarding platelet count) would probably also be at risk.