APS - Antiphospholipid Antibody Syndrome: When to take blood thinners?

Neikoda · February 2016

Hi ladies-

I'm visiting over from the TTC boards and after searching and searching I am unable to find an answer to when, on average, your APS blood results warrant taking blood thinners. I recently tested positive for APS with an Igm of 15 and then 25 six weeks later. My OB/GYN wants me to wait until after I become pregnant again for me to meet with the specialist and decide whether or not to put me on the injections. Since I've had an issue of recurrent early MC's, I want to take the blood thinners as soon as possible to prevent another loss. They said over 40 and they definitely put you on the medication but from 20 to 40 it's up to the specialist. Just trying to see what other women have had their levels at before treatment. Thanks!

jolydan · February 2016

I recommend consulting with a high risk doctor for a pre-conception consult. He will send your OB the guideline to follow. In my case (and I'm not telling you to self medicate because my problem is not the same as yours!!) it was baby aspirin at preconception, then injection starting at 8 weeks and then combo of injection + baby aspirin starting at 12. The OB had no words to say about it, they will just follow guidelines. Also you'll probably have to be followed by a high risk doctor anyways so better touch base before all the craziness of early pregnancy starts.
Also, if you had an early loss it's unlikely caused by the syndrome as you don't share blood connection with the baby until week 6ish and even later. It's often an unfortunate even, so don't blame yourself or think things done differently would have change the outcome, you'll just hurt yourself

Neikoda · February 2016

Thanks for the response @jolydan. I was told that APS contributes to implantation issues as well before blood clots in the placenta are even a possibility. Since I don't turn a positive test until 15-17DPO, I believe it's affecting my ability to implant properly. My OB/GYN has lined up a high risk doctor for me but claims I don't need to go to a consultation with them until after I get pregnant again. I'm nervous that by the time I get in to see the specialist, it will be too late. I'm just trying to be proactive instead of retroactive. I requested to meet with specialist before TTC again to hopefully at least start an aspirin regiment before conception.

bsckgb7 · February 2016

I have APS. I was on baby aspirin pre-conception and started on Lovenox from 2 days post BFP (after confirmed by RE). It took a few days for the pharmacy to get it in, otherwise it would have been day when the RE confirmed pregnancy. I will continue aspirin and Lovenox for the duration. In the 9 month, I will switch to Heparin twice daily. I have an extremely mild case (some of my doctors, argue I don't even have it). I went to MFM (high-risk doc) for a pre-conception appointment and they decided the protocol (but that was the REs protocol even before the MFM was involved)

Sally1990 · February 2016

I would find a hematologist soon. I have a blood disorder and they thought for a while I had aps but after many test I don't. But I still meet with my hematologist and s high risk ob when ttc. If you have had losses I would think you need to be on something while ttc or at least that's what they had me do after my two mc. Good luck, I hope you get some help and answers soon.

jolydan · February 2016

You could also ask the high risk doctor about low dose of prednisone. It helps for those who have autoimmune diseases and antibodies that attack the blastocyst. You can ask your PCP for a referral if your OB is being stubborn!

Neikoda · February 2016

Thanks @bsckgb7. I just got approval from my OB/GYN to go for a preconception appointment if I felt it necessary. I just want to know what the plan of action is before I get pregnant again, not wait until I do and hope it's not too late.

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APS - Antiphospholipid Antibody Syndrome: When to take blood thinners?

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