XP: back from my recurrent-miscarriage follow-up with the OB

AustinBride06 · July 2011

I promised some of you an update so here's the LONG version!

Brought a page-long list of questions for her and printed out my Fertility Friend charts and everything. She was great, she went through every single question with me. Basically... I do have one copy of the MTHFR mutation c677t in addition to being positive for ANAs with a speckled pattern (a possible lupus indicator). Just one or the other wouldn't be too worrisome, but having both is cause for some concern. I did not test positive for the lupus anticoagulant, but lupus is so hard to diagnose and I could still get it in the future based on my ANA titer and speckled pattern result. I did not test positive for any hereditary thrombophilias.

So the plan of action for now is to start taking baby asprin and industrial-strength folic acid (4mg versus the usual 800mcg in prenatals) every day. Then after I O, I'm supposed to start prometrium 1x day until I get a positive HPT. Then I go up to the regular prometrium dose and start Lovenox injections. Lovenox is a blood thinner so I'll have to get my platelets checked once a month for a little while to be safe. If I don't get a positive HPT by 14dpo on a cycle, I'll go in for bloodwork just to make sure I'm not PG and if I'm not then I stop taking the prometrium so I can get my period and start over again.

Sounds complicated, but honestly (except for the injections, which I'm a little nervous about) it was the best-case scenario based on what's been going on. She said I could go see a rheumatologist for further testing about my ANAs but she said that since I'm young and not having symptoms, she doesn't think it's totally necessary yet while I'm trying to get pregnant because anything stronger than the lovenox I wouldn't be able to take while TTC or pregnant anyway. Once I get pregnant again and get past the 1st tri I'll probably get sent to a maternal fetal medicine specialist just to double check things since I am definitely now considered high-risk. Also am going to be at a much higher risk for pre-eclampsia so I might have to start looking into better remote-access solutions at work if bedrest is going to be in my future! Ugh. And since I'm also at a higher risk of pre-term labor, probably will be looking into hospitals with higher-level NICU's than where my doctor delivers eventually, just in case. But it's all worth it to me if I can get a take-home baby! Luckily I don't seem to have too much trouble actually getting pregnant (though you'd better believe I'm going to be chugging that pomegranate juice and popping the mucinex on the next cycle!) so I really hope this will help solve the staying-pregnant part of the equation.

I have to admit, I'm totally geeking out on all these statistics and lab results and protocols. It makes me feel SO much better to have some answers and a plan. She didn't really think any further testing was necessary right now. If I had gotten further along or if this bloodwork had come back all negative or inconclusive she might have, but she feels that this is more than enough for us to work on for now. She did say that she felt that I miscarried for different reasons this time than last time... which does worry me a bit... but I still feel confident that I'm being put on the right course of action.

texasmeg1 · July 2011

Wow you sound so educated on the subject! Glad you are pleased!

AppleJack83 · July 2011

Congrats! sounds like you have a solid plan. I take Fragmin (which is often prescribed in Canada instead of Lovenox, but is basically the same thing) injections when PG. I would reccomend looking up some stuff online first. The injections sting if you go too fast, the trick is to go slow. There are all kinds of tricks that helped me out.

You're lucky your doctor is monitoring you while on Lovenox and Prometrium. My Dr gave me the scripts and basically said GL. You've got a great plan!!