Thanks Rozzie. I'm digesting your advice. I just wish I knew his reasons for waiting until the 6 wk mark. He was very definite with me about that even when I questioned it. He even cut me short and called me 'stressed' which was a surprise. I don't feel I can ask him to prescribe the clexane earlier because of his inflexible attitude on the day we saw him. I tried before I was even pregnant then.
The dilemma would be getting copies of all the results and getting a referral and into another specialist before next Wednesday. I feel like my hands are tied and I'm trying not to panic. Hopefully as you say, the aspirin might help this time. I'm now wondering if the early losses were to do with the MTHFR and the megafol might be his reason for not rushing the clexane but I don't know. (He didn't have the embryo karyotyping results when we visited him in July.)
If you are seeing Dr S I know he is reluctant to begin clexane from a bfp. He also told me to commence after "fetal hearbeat has been seen" at 6ish weeks.
I too have done a lot of study on this - the risks outweigh the benefits imo of beginning the clexane at a bfp. My obs was also of the opinion that it should be commenced from bfp. Some even commence it during the luteal phase.
The placenta begins to form at conception - or at least the framework for it does. It can be argued that this is good enough reason. That was my reasoning anyway.
I would plead and beg cry and put on a tanty. This is your body, your baby, your call.
I was commenced on aspirin and clexane at a viability scan for my son (I am now allergic to clexane so that management plan has been lost). I have Factor V Leiden. When discussing the risks of ceasing the clexane with my OB (and debating whether to try an alternative) we determined the literature supported the use of aspirin for placental implantation and the clexane was more for my risks of clotting, rather than the implantation of the placenta. My issue related to placental implantation with my stillborn daughter which may be different for you.
If you are concerned then ask your FS to explain their reasoning behind the management plan. They should be able to give you valid and supporting evidence. If not, then you need to question why the alternative plan is not one they are recommending. Good luck and join us in the other sections
Well, thank you all again because you have given me the courage to question my FS' management plan. The plan may be the best one for my circumstances, but I need to understand it better. Nothing ventured, nothing gained!
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