Lupus and thrombophilia

Isabelle

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Reply Lupus and thrombophilia Posted on: Nov 22, 2010 at 3:29pm
Dear Dr. Braverman,

I am a 27 year old female, living in Europe (Belgian but living in Prague, Czech Republic). My husband and I have been trying to conceive for 17 months now and it looks that we are experiencing primary infertility. We have both been examined (sperm, HSG, hormones...) and all looks fine. We do know that I have SLE (without symptoms so far) as well as thrombophilia (3 mutations: V Leiden, FII-prothrombin and MTHFR, all heterozygote). My gynecologist keeps telling me that this does not affect my chance of conception. He says it could increase the risk of miscarriage or stillbirth later on but it should not cause primary infertility. When I surf on the Internet, however, I read everywhere that it could be the cause of me not getting pregnant... I have the feeling that my gynecologist is not taking my condition seriously and will not treat my infertlity properly. He is proposing to put me on Clomid and progesterone, even though my ovulation and hormones are fine. Is my gynecologist doing the right thing, because I am scared he is not...? (When searching on the Internet, I find that US clinics are much more specialized in immunity-related infertility.). Thank you! Isabelle

Dr. Braverman

2016 Posts
Re: Lupus and thrombophilia Posted on: Nov 22, 2010 at 3:48pm
H Isabella, I think your lupus is a much more important issue that the thrombophilia a this point. Patients with autoimmune syndromes have a more difficult time develeping immune tolerance to their embryos as they have lost some of the ability to tolerate their own cells. I do disagree with your GYN however, when there are no other issues ( and I believe there are) then these significant thrombo findings when treated early have led to pregnancies in our experience, but as he claimed(or she) most patients with these findings get pregnant but miscarry.
I suspect your lupus is the primary issue here.
Feel free to fill out a patient quetsionnaire and call for a consult, we take care of many overseas patients. This is not difficult as most of the diagnosis and management can be done by telephone.
Let me know if I can be of service to you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Isabelle

0 Posts
Reply Re: Lupus and thrombophilia Posted on: Nov 24, 2010 at 2:21pm
Thank you very much, Dr. Braverman, for your fast reply!!
I just took a look at the online questionnaire and see that you are asking questions and details that none of my 3 gynecologists have asked or checked (but details that I have been thinking about and could be important!).
I am scheduled for 2 consultations at my GYN/fertility specialist this week and next and will await their comments and actions.
I might call your Institute soon though, just to check how things would work from overseas (social security, fees and payment etcetera).
My aunt had to travel to the US to get pregnant years ago, because nobody here could help her ... I hope of course it will not be my case, but just in case, I know where to go now
Thanks again,

Isabelle

Dr. Braverman

2016 Posts
Re: Lupus and thrombophilia Posted on: Nov 24, 2010 at 6:01pm
My pleasure , good luck
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.