HELP, multiple misscarriages
4 Replies
heather k - May 17

Just looking for some advice. I had a son almost 5 yrs ago ( perfect preg) then I had 5 miscarriages-latest one made it to 20 weeks. After the third misc. I was diagnosed with hetero MTHFR. They started me on lovenox 40 mg, along with B6, B12, 4mg folic acid, and baby asprin. 4th misc. was a blighted ovum. 5th misc made it to 12 weeks. I thought the lovenox would fix the problem. I am thinking there must be something else going on. Any advice as to what else they could test for next? Thank you so much!


Dr Smith - May 17

Well, the MTHFR mutation is likely contributing to the problem, but there may also be autoimmune issues. There is testing and treatment options for autoimmune disorders that result in miscarriage (see or for more info). Recurrent miscarriage can also be caused by genetic abnormailties in the developing fetus. The rather outdated term "blighted ovum" refers to an embryo that developed without stem cells, so that only the sac was visible on ultrasound (no fetus). If you are getting older (i.e. >35), genetic abnormalities in the fetuses may also be contributing. Were karyotypes done on any of the products of conception following the D&C? My hunch, and it is only a hunch, is that your problem is multifactorial. I would suggest further testing. If there are no autoimmune problems, you may benefit from IVF with pre-implantation genetic diagnosis (PGD) to identify and transfer only "normal" embryos.


heather k - May 17

Dr. Smith,

Thank you for responding! The websites you gave me were very informative. To answer some of your questions--I am only 29 years old. As far as testing goes on products of conception--

1st misc.-16w- pathology only-fetus and immature placenta with areas of acute inflammation, degeneration, and hemmorhage. Report said "no areas of abnormal findings."

2nd misc.-10w-chromosones tested--normal female

3rd misc.-20w--afp test was high for nueral defects--level 2 sono showed fetus with a twisted spine, and no movement. I am guessing this was related to MTHFR and the folate issue.

Here is were I was diag. with MTHFR and began meds and vitamins

4th misc.-8w--blighted ovum--misc. on my own. no testing

5th misc.-12w--still waiting for results.

My doc has mentioned trying prednisone next time. I assume they may be thinking its a autoimmune thing also. Hopefully they will do more testing first. I don't know if that will be with or without the lovenox. I sometimes wonder if 40mg was not enough and maybe that is were the problem lies?
Any info on the prednisone as treatment? Thank you so very much for your time. I think its great you are trying to help those reaching out to you!


Dr Smith - May 18

I've reached the limit of my expertise. Why don't you post your history on Dr Jacob's Infertility 101 Message Board. He will probably know more about this than I do. Sorry, but "A man's gotta know his limitations" (Clint Eastwood as Dirty Harry, 1974).


heather k - May 18

Dr. Smith,

Thank you for responding. I will try Dr. Jacobs board!

heather k



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