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shrek - January 8th, 2007 10:52 AM

I was just informed I am currently experiencing my third miscarriage in a year and a half. I was dx with hetero C MTHFR this past June, after my second m/c and was put on aspirin, prenatal, and metanx. I thought that would do it. When I became pregnant this time around, I asked for lovenox, but was told it is not protocol for my specific type of genetic mutation. I lost the pregnancy within days of finding out about it.
How could a doctor know whether the loss is due to a need for a stronger blood thinner like lovenox or due to some other reason like a "bad egg", bad sperm, etc.
at such an early stage of loss? Also, how could a doctor know what to prescribe: heparin or lovenox???? I keep reading that every doctor is doing something different for their patients with this specific condition, and they all seem to be in the dark about this. My question is, how do you treat this to avoid recurrent losses, if you can't pinpoint the cause of the loss for sure, and also if it is due to blood clots, how can a doctor know what and how much to prescribe without just guessing and risking further horrendous attempts that end similarly?

B. Jacobs, M. D. - January 8th, 2007 5:22 PM

Tee accepted protocol for evaluating recurrent pregnancy loss is to start the evaluatioin after the 3rd loss. There are certainly more common causes of pregnancy loss than immune issues. Infortunately, I do not have your medical records, and cannot advise you.
Good luck.

shrek - January 8th, 2007 6:58 PM

I know that you must mean well, but I feel that you did not read my message thoroughly. I asked general questions about how a doctor decides on lovenox vs. heparin (ie: is one stronger, known to be more appropriate for certain disorders, etc.)? I understand that my doctor may choose to look further for other causes of my difficulty carrying, but this protocol of discussing after 3 m/c clearly isn't protocol, as my RE chose to do tests after my second m/c. Telling me perhaps that more will be done since this is the third is only telling me that you have nothing to say and that I should just talk to my doctor. If you knew something about MTHFR and of popular methods of treatment and statistically the results, that would've been helpful, and perhaps more of what I was looking for. I did not find this forum helpful. I got more out of communicating with so called "laymen" who had to weather this themselves and gathered information from personal experience. THis condition appears to be much more common than people are aware of, and considering that, I think fertility doctors should be intimately familiar with it.


B. Jacobs, M. D. - January 9th, 2007 5:05 PM

Lovenox is low molecular weight Heparin. Although ot is very uncommon, there is a disasterous side effect of unfractionated Heparin. In a few people it can wipe out the blood platlets, which play a key role in clotting. Low molecular weight Heparin like Lovenox does not carry that risk.

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