RPL with APS

MelissaK

0 Posts
Reply RPL with APS Posted on: Mar 18, 2011 at 2:08pm
Hi Dr. Braverman

I am really hoping for your opinion.....

I have a 4 year old and then we have 3 losses. Our first loss was at 13 weeks....I delivered at home, I believe something along the lines of pprom is what happened. I had visable cramping on my ultrasound the day it happened, baby was still alive, but had a elevated heartrate. they sent me home to put my feet up....and I delivered. The second loss I was 18 weeks, they think the baby passes at 17 weeks.They didn't find any clots in the placenta or cord, nor did they find anything else visably wrong. I was diagnosised with APS, and compound heterozygous for MTHFR. My third pregnancy I was on BA and started lovenox after confirmed pregnancy test. I was also put on progesterone because my levels were low. I lost that one at 7 weeks after seeing the heartbeat.

After this I went to an RE who has experience with RPL

My APA panel came back with 9 positives and 4 borderlines.
I am currently on Dexamethason, lovenox, baby aspirin, folgard, and metformin (I also have PCOS) and I will be adding crinone 3dpo this cycle. I am doing all this while we are trying.

I guess my main question is....what are my odds of actually carrying to term?

Thank you,
Melissa

Dr. Braverman

2024 Posts
Re: RPL with APS Posted on: Mar 18, 2011 at 2:52pm
I have no doubt you can carry a pregnancy to term, I think that with a failure on lovenox , you cant rely on just the fact that the lovenox was not started on time and you should also complete the workup with immune testing as well. I would be happy to guide this part of your workup.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.

MelissaK

0 Posts
Reply Re: RPL with APS Posted on: Mar 18, 2011 at 3:47pm
What further testing for the immune work up would you suggest??
I have had the APA panel, Natural Killer Cell, karyotyping, untrasounds, fragile x, the last pregnancy I had a ton of swabs done for infection. I have also had hormone levels tested, thyroid, diabetes, vitamin deficiencies, and other things I don't remember off the top of my head.

All my losses have had extremely low and slow to rise HCG.

Thank you again,
Melissa

Dr. Braverman

2024 Posts
Re: RPL with APS Posted on: Mar 19, 2011 at 2:48pm
I would have to see what immune testing you've had to date. Many centers run a "Natural Killer" cell test but that is not a full immune panel and does not give you insight into immune related pregnancy loss. If you could post what you have had done and Ill let you know if it was complete. I hope I can help you.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.