TTC After a Loss 6 Months+

S/o MTHFR, I'm confused...

I'm looking through my medical records and all my RPL results and I don't see where they tested for MTHFR.  But they did test homocysteine levels and that was normal.  Do they only need to run the MTHFR test if the homocysteine level is elevated?
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4 early losses 2009, 2010, 2015.  Baby #1 born 2/13/11.  

Re: S/o MTHFR, I'm confused...

  • That's a good question. They ran the MTHFR test on me, and now we have to look at my homocysteine levels to see what's going on. So we did it the reverse order.

    But it would make sense that if those levels were normal, they wouldn't need to run the MTHFR screen. At least, that makes sense to me.

  • In my records I have this test seperate from the homocysteine, MTHFR MUTATION.

    I had 11 tests that day. If you want me to write them all out I can.

    ETA: I had both ran, and I was + for one MTHFR gene/mutation, but my homocysteine was normal.

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  • Huh.  I guess there's at least reason to ask about this when I go in on Monday.  Thanks, ladies.
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    4 early losses 2009, 2010, 2015.  Baby #1 born 2/13/11.  
  • they did both of mine at one time
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  • I'm not sure.  I just looked at my print out from the last set of labs and I didn't see MTHFR on there either, but they did test homocysteine level.  Is factor 5 leiden mutation different than MTHFR?
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  • imagePeetiePie:
    I'm not sure.  I just looked at my print out from the last set of labs and I didn't see MTHFR on there either, but they did test homocysteine level.  Is factor 5 leiden mutation different than MTHFR?

    Yeah, they're different.  I was tested for Factor V and homocysteine, just not MTHFR.

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    4 early losses 2009, 2010, 2015.  Baby #1 born 2/13/11.  
  • imageBBHME:

    imagePeetiePie:
    I'm not sure.  I just looked at my print out from the last set of labs and I didn't see MTHFR on there either, but they did test homocysteine level.  Is factor 5 leiden mutation different than MTHFR?

    Yeah, they're different.  I was tested for Factor V and homocysteine, just not MTHFR.

    Well I guess I wasn't tested for it either.  Strange.

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  • imagePeetiePie:
    imageBBHME:

    imagePeetiePie:
    I'm not sure.  I just looked at my print out from the last set of labs and I didn't see MTHFR on there either, but they did test homocysteine level.  Is factor 5 leiden mutation different than MTHFR?

    Yeah, they're different.  I was tested for Factor V and homocysteine, just not MTHFR.

    Well I guess I wasn't tested for it either.  Strange.

    Sorry to butt in ladies. I think you need to specifically request to have your clotting panel tested, which they don't normally screen for unless you ask. The test is very expensive and even the best insurance companies often don't pay for it unless there's a "reason" other than routine. Mine was about $2200 and it took months of fighting and my OB writing letters to get ins to cover it. HTH!

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  • imagesydney0928:
    imagePeetiePie:
    imageBBHME:

    imagePeetiePie:
    I'm not sure.  I just looked at my print out from the last set of labs and I didn't see MTHFR on there either, but they did test homocysteine level.  Is factor 5 leiden mutation different than MTHFR?

    Yeah, they're different.  I was tested for Factor V and homocysteine, just not MTHFR.

    Well I guess I wasn't tested for it either.  Strange.

    Sorry to butt in ladies. I think you need to specifically request to have your clotting panel tested, which they don't normally screen for unless you ask. The test is very expensive and even the best insurance companies often don't pay for it unless there's a "reason" other than routine. Mine was about $2200 and it took months of fighting and my OB writing letters to get ins to cover it. HTH!

    This was part of my RPL. I didn't have to pay anything out of pocket for it.

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  • The MTHFR mutation is fairly common - about 40% of women tend to have at least a single heterozygous mutation.  Often single or even double hetero mutations do not cause a raise on homocysteine levels and thus are considered minor. 

    My guess is it's a time/money saving measure (and perhaps worry saving?) on the part of doctors.  If you have a homozygous mutation on one or two genes, the consequence is an increase in homocysteine levels in the body.  THAT is when it becomes dangerous.  If you skip the genetic test and simply scan for homocysteine, you can get a broad picture of health/not health without needing or seeking the specifics.  My guess is if your homocysteine came back elevated, they'd delve deeper into the issue, but that the doctor (or insurance) delayed the MTHFR test in order to see the homocysteine levels first.

    Does that make sense?  I'm hetero for A1298C MTHFR, but it's rather meaningless because my body accomodates for the difference.  Any treatment is considered prophylactic. 

  • I will say, the MTHFR screen was part of my RPL panel, and I didn't pay extra for it - I think I saw on the bill it was around $300 or so.

    And Monica brings up a good point - there are so many variations (homo/hetero, one strand or two, etc.) and some are more common than others. So, if your homocysteine levels are low or within "normal," then they can probably just stop looking.

     

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