PAI-1 4G/4G and RPL

Kg14

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Reply PAI-1 4G/4G and RPL Posted on: Dec 7, 2011 at 3:58am
Hello,

I am looking for information on PAI-1 4G/4G. I gave birth to my son at 38 years old with no complications. I am now 40 and in the last year I have had 3 miscarriages with unknown cause between 6-8 weeks with no heartbeat ever detected. Only finding on complete RE work up was PAI-1 4G/4G and borderline LPD (serum progesterone 14-17 at 21 days). Progesterone found to be low in first two miscarriages (8-11) but fine in third 19 to start.

RE's protocol is clomid for ovulation and lovenox post positive HPT. I am not comfortable with lovenox injections. Is this the only treatment option available or even necessary? Are there any less invasive or natural options?

Best,

Kim

Dr. Braverman

2017 Posts
Re: PAI-1 4G/4G and RPL Posted on: Dec 7, 2011 at 5:10am
this polymorphism has been associated with insulin resistance so a full w/u for PCOS must be done and sometimes the treatment lies in that diagnosis. As you can see from my PCOS video(yes I know I need a shave) this treatment is multifactorial. this polymorphism can also lead to clotting issues as well and yes sometimes lovenox is necessary. I would be happy to help guide your workup. Feel free to call me and schedule a telephone or skype consultation. Low progesterone is almost always a result of but not the cause of early losses.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

Kg14

0 Posts
Reply Re: PAI-1 4G/4G and RPL Posted on: Dec 8, 2011 at 4:18am
Thank you. I will call and make arrangements. One follow up question. Does a glucose tolerance test (3 HR) rule out PCOS? I did have this test and was told my results were excellent. What does a full w/u for PCOS mean?

Dr. Braverman

2017 Posts
Re: PAI-1 4G/4G and RPL Posted on: Dec 9, 2011 at 7:48pm
no a GTT does not rule out PCOS, there are too many variables in PCOS for one test to rule it out.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.