If you have homozygous MTHFR & Factor V Leiden ...

na24

... can you tell me a little about your protocol?  I have a friend who has both of these issues (and has had two miscarriages) and she's feeling like it's a really daunting diagnosis.

Temp893722312503334

My protocol has been aspirin and extra folic acid.  the day of transfer I started 40 mg twice a day of lovenox and stayed on that until 36 weeks when I switched to heparin.  

My MFM doctor said that the lovenox was probably overkill but we both agreed that it wouldn't hurt and if it made me feel better we should do it.  

It was a lot, especially first tri when I was also on PIO but it the end it was all worth it and I do it again in a heartbeat.  

Lots of luck to your friend. 

smeyer

I'm homozygous for Factor V Leiden and hetero for MTHFR.  I had 4 m/cs prior to our "take home" twins but none were directly related to either disorder.  (M/cs from clotting issues tend to be late 1st tri or early 2nd losses and mine were all by 10 or 11w.)

I always take an extra 4mg of folic acid as a c.y.a. for the MTHFR.  For the FVL...  I started Lovenox (40 mg once daily) with stims.  For fresh cycles, I took a break before and after ER because it takes 24 hrs for Lovenox to leave your system.  Once pg, I kept up the once daily Lovenox until I was 12 w.  When I met with my MFM, he increased my dose to twice daily.  Since I was pg with twins and would likely deliver earlier than a singleton pg, I was going to be switched to Heparin at 34w (36-37w is common for singleton pgs).  When I went to my 33w appt my pre-e was severe enough that my OB made the call that the babies would come the following day.  I never made it to the switch to Heparin but I did have to wait 24 hrs before my c/s so I wouldn't have any bleeding issues during surgery. 

LucyPevensie

On my IUI cycle that worked - I was taking a prescription folic/b tablet called FOLTX - now I take one called Folbic. I was also taking 81mg low dose aspirin every day - and a fish oil capsule. At 2dpiui (so before implantation) I started 40mg of Lovenox (it's an injection.)  I was on Lovenox my entire pregnancy until at 36 weeks they switched me to injectable heparin.  I also stayed on the low dose aspirin, fish oil capsule, and FOLTX the entire time.  No problems, everything went great.  I have the exact same diagnosis as your friend.  Tell her best of luck from me!!