RPL - Lovenox

[Arti]

I have high levels of PAI, low Protein C level and High phosphtidylserine IGM AB levels and have a history of 3 recurrent chemical pregnancies ( 2natural conception and 1 IVF), all the other tests seem normal including lupus anticoagulation and Cardiolipin antibodies, My RE asked me to start Lovenox after a positive HPT, but I lose the pregnancy immediately after positive HPT..what could I do differently, is this impairing my implantation?.. Does my condition cause chemical pregnancy.. is my diagnosis APS or thrombiphilias. Please help.What can I do to improve my chances in my next IVF cycle

[Scott Roseff MD]

Hi,
You need to gather up your records and have them reviewed, in-depth, by another Board Certified RE, for a second opinion. Something may have been missed, or something may have been misinterpreted, and you should consider having someone else take a fresh look at your records/results to make sure this wasn't the case.

For example - Was your protein-C level measured during, or within 6 weeks after, a pregnancy? If so, it may have been low (and may be normal if it was). What did your partner's sperm DNA decondensation (SDD) assay show? Abnormal SDD can potentially cause miscarriage in a high percentage of cases.

Hope this helps!

[Arti]

Hello Dr - Thank you very much for your response.really appreciate it. I live in FL and will work on scheduling a consultation with you for second opinion to review my records in more detail.My protein C levels and 21 point APS antibody screening , PAI-Fx screening was all done 11 months after my miscarriage. The tests were done 6 months apart and PAI-1, Protein C came back abnormal again with High PAI 1 and Low Protein C.The Dr said I seem to have peri- implantation miscarriages( all 3 times since low HCG was always detected) as it has always been between 5-6 weeks.My HSG was normal and my husband's semen analysis was normal. I have PCOS and my IVF meds were metformin,BSAand Dexamethasone. we had very beautiful blastocysts during our IVF cycle, Do you think taking Lovenox after IVF/ET could have prevented the miscarriage?.. just trying to perform a postpartum on my IVF . Thanks.

[Scott Roseff MD]

It's hard to say, "Arti", but I look forward to reviewing your findings. If you do want to schedule a second opinion consultation, we're at 561-333-8232. Looking forward to meeting you and trying to solve your IVF problems!