RPL and MTHFR

callie13

1 Posts
Reply Posted on: Feb 10, 2012 at 11:42am
Hi Dr. Braverman,

I am writing to ask about your experience with MTHFR. I found out after my 8th pregnancy loss that I am homozygous for C677T. I pretty much demanded that I be checked for this after reading a couple books about the mutation. My homocystein and folate levels were aparently normal so my doctors said it wasn't necessary to check. Now that we know I am positive, I still get the same message (that it's not important because my folate levels were fine). I have done a lot of research and I keep finding that having this mutation (even with normal homocystein levels) can indeed be a cause of RPL. I have been to just about every OB and high risk doctor (and all fertility doctors) in our area.

My most recent loss was in my second trimester and was devastating. I have had placental abruptions and bleeding with every pregnancy. I feel there has got to be a cause but can't find anyone willing to help me. I'm told to follow the usual RPL protocol of baby asprin, prenatals, fish oil, vitamin d, and progesterone. Is there anything else I can do? I've used Lovenox and IVIG but lost those pregnancies too.

Also, I have read that in some cases, the spouse can have the mutation making things more challenging. I asked our fertility clinic for a lab requesition for my husband but they wouldn't give me one ("it wasn't necessary"). Do you agree?

Dr. Braverman

2016 Posts
RE: RPL and MTHFR Posted on: Feb 10, 2012 at 1:27pm
Im not sure if its the MTFHR or some other thrombotic issue, but certainly with the failure to respond to lovenox it means one of two things

1. your level of lovenox is too low(did you have an anti XA level drawn)
2 You have an immune issue that is unrelated to the MTFHR.

You certainly need a full immune workup at this time as although if nothing is found I do beleive the MTFHR is playing a part and should be treated, but it is still not the most likely cause.

I would be happy to help guide your workup and management which we can do where ever you live. Please call my office and schedule a telephone or skype consultation. I look forward to helping you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.