Auto Immunue Disorders

JourneytoJoy07

I am back after taking a break during the middle of my 3rd IVF cycle.  I was so blessed to be able to conceive on this try with what seemed a normal pregnancy after a 3 week duration of beta hell the previous cycle.  At exactly 7 weeks we saw a beautiful heartbeat, only to have the baby taken from us that very same day in a rapid miscarriage.

The RE ordered the miscarriage panel, and I just recieved the results today.  I am hoping someone is familiar with one or any of my results.  The APRN said I need to go see a rhemutologist to have all of this explained in more detail.  Here are my results.  I apologize if they are unclear, it's all scribbles on my paper.

 

-Abnormal ANA 

- Type A Sjogren's

- Elevated plasminogen activators (normal 4-43) mine is a 64. 

 

Talked to RE quickly and he mentioned it was great to finally have answers and that we will  do heparin 3x/day or lovenox next time in addition to anything I have to do to balance the things mentioned above.  Towards the end he mentioned worse case scenarios and said the increase of meds could put me at risk for preclampsia and possible miscarriage and that if that happens our next step is gestational carrier.  He said adding the above could be all we need but he wanted me to know the worse case..needless to say there has been a lot of crying this evening.  I am very sad/upset/confused and hoping someone is familiar.  Thanks in advance.

katharine25

I was diagnosed with abnormal ANA's and Sjrogens, as well as being homozygous MTFHR. I don't know anything about the plasmogen... I had one clinical pregnancy where the babies heart just stopped at 12w1d, followed by 3 chemical pg's at various lengths, one was two weeks of beta hell and suspected ectopic. For the MTHFR my RE prescribed 40mg of lovenox, which I was supposed to take at a BFP. I did that one cycle and had a chemical, so the next cycle I actually started at 3dpo. That protocol resulted in this pregnancy making it to clinical status along with a high dosage preventative progesterone treatment. At 5w4d, when we confirmed the presence of a gestational sac, I started a low dose of medrol [a version of prednisone]. By early second tri I stopped the medrol and progesterone. I'm still on lovenox, but my MFM and OB have both said its ok to stop if I wanted since "MTHFR isn't really a thing". I disagree with that statement and stay on it because if I stopped and something happened to this baby, I could never forgive myself. It's also considered to be a low risk medication. (It does require some additional discussion in regards to labor & delivery)

Overall, my MFM has always been most concerned about the Sjrogen antibodies... Even with everything in this pg being absolutely perfect. I have ultrasounds every other week, need to be delivered by 40w, and that's basically it -a TON of monitoring that has shown a perfect growing baby.

 I will add, I had bloodwork done just before this BFP for my annual exam, and at that point, 4 months after the bloodwork from my RE, my ANA's were actually normal and the Sjrogen's was not present... So that leaves some questions ill never really have answers to; was all the medications even necessary? Did this pg work because the antibodies were gone? Is it all really just dumb luck with no explanation? Part of me truly believes I would never have made it to this point without Lovenox and the other drugs, the other side wonders about the big unknown...Either way here I am at 34 weeks and I have no regrets about any of the meds I've taken, and would do it all again to have been able to make it this far.

The good news is the antibodies can go away on their own and even if they don't there are treatment protocols in place. If you haven't already, I would recommend reading Dr. Beers book "is your body baby friendly" and exploring the reproductive immunology yahoo group; there tons of very knowledgeable women there that have lots of experience with immune issues. Dr. Braverman's blog is also a great source, and he's pretty responsive on his Q & A.

wiechs22

I have an abnormal ANA, positive rheumatoid factor, and 2 copies of a mutation involving plasminogen activator inhibitors. My original plan of care was lovenox as soon as I got a bfp. I ended up getting pregnant with this baby before we found out about the pai1 thing and there is a bleed around the baby so I haven't been able to start Lovenox. By some miracle I am still here. My rheumatologist is just having my blood work checked every 6 months for now.