Count down to 6 wks to commence Clexane

[Miss Lizzy]

I'm new here but have read some helpful information and wonderful supportive comments. I'd like to know if any of you have had a similar wait as I'm having before commencing Clexane.

I've had 3 early losses after our DS who is now 2.5 yo. I was found to have MTHFR, raised homocystein, a slow TEG and ACAs. This is my first pregnancy after we received these results and the plan is: aspirin as soon as pregnant, 5 mg folic acid and prog. pessaries and at 6 wks, an u/s and then commencing Clexane.

I'm 5 weeks on Wednesday. I'm seeing a well reported IVF clinic / FS who I thought would do more frequent early monitoring, but last week after the two betas and prog. tests, that's it until the 6 week scan. It feels like a long 2 weeks from then until the scan.

My concern is that I haven't made it to 6 weeks for the last 3. My FS didn't appreciate me saying that when he was stating the 'plan'.

I'm reminding myself that some things are different this time like the megafol and prog. pessaries. (The aspirin was tried previously.)

With my DS I had horrendous m/s but that started at 9 weeks and went to 23 weeks, so I don't expect to have that soon. For those interested I had pre-eclampsia with him too, maybe that's related to the clotting issues.

I'd love to hear from any of you who've had a similar start. As you will understand, every day until the scan feels like an eternity. TIA.

[Inanna]

Welcome Miss Lizzy to Belly Belly and congratulations on your pregnancy.

It is a really really difficult road to travel when pregnant after many losses. You may like to join our Preganancy after Late Loss/Stillbirth/Recurrent Miscarriage thread. There are many beautiful women to help you through.

I was on clexane during my last pregnancy. I commenced on the clexane from a BFP. I was also on asprin, mega folate and prednisone. I do know that some women commenced on clexane from "evidence of a viable pregnancy" and some specialists follow that route.

Hopefully some of the other women who have been on clexane will come in and tell you their stories.

Wishing you a long and healthy pregnancy.

[Rozzie27]

Hi Miss Lizzy,

I have anticardiolipin antibodies as well. The treatment is the same, aspirin and clexane.

I have done a ton of research since my loss, and most caregivers familiar with clotting disorders in pregnancy will start clexane at the first + pregnancy test. Some still want to wait until a heartbeat is detected. Many women have successful treatment this way, but some do not.

If I were you I would either push to start the clexane now, and if your doctor refuses see another. Even if it ends up being unnecessary, at 40mg clexane daily there is very little risk in starting the clexane now, so better to be safe than sorry. Having said that you are on apsirin and that may be enough to tide you over.

Also, there is a Hughe's syndrome support group for pregnant and TTC women with the clotting syndrome, if you're interested I can give you the link. The women in it are very knowledgable and suppotive.

Good luck,

Rozzie

[Miss Lizzy]

Thank you Flowerchild. I will join the pregnancy group you mentioned. They sound wonderful.

I'm feeling confused and frustrated about why my FS is starting me at 6 wks when I know from old threads, he's the same dr as so many of you have had and he started earlier. I just don't feel 'safe' at the moment. But I can't argue with him, I won't win and I really do just have to bide my time. Only 9 more sleeps I guess..

[Miss Lizzy]

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.)

[Inanna]

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.

[Michelle71]

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

[Miss Lizzy]

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!

[mina74]

Hi Miss Lizzy,

I have anticardiolipin antibodies as well. The treatment is the same, aspirin and clexane.

I have done a ton of research since my loss, and most caregivers familiar with clotting disorders in pregnancy will start clexane at the first + pregnancy test. Some still want to wait until a heartbeat is detected. Many women have successful treatment this way, but some do not.

If I were you I would either push to start the clexane now, and if your doctor refuses see another. Even if it ends up being unnecessary, at 40mg clexane daily there is very little risk in starting the clexane now, so better to be safe than sorry. Having said that you are on apsirin and that may be enough to tide you over.

Also, there is a Hughe's syndrome support group for pregnant and TTC women with the clotting syndrome, if you're interested I can give you the link. The women in it are very knowledgable and suppotive.

Good luck,

Rozzie

[mina74]

hi, just a quick hello and to ask if you could pass on the site for the hughes syndrome support. Im so sorry for the loss of your little one, even after a year and a half after the loss of my little girl Sabrina I still feel lost without her. Im 16 weeks pregnant now and on clexane and asprin and trying to stay strong. I had no idea that there were so many of us out there with this problem. Im having problems sleeping as all I think about is if all this stuff that im taking is really working and it would be great to hear of some positive pregnancy outcomes. Thanks so much mina

[Rozzie27]

Hi Mina,

I tried to personal message you with the links, but couldn't for some reason, can you message me and I can reply