Is clexane used instead of baby aspirin? Or in conjunction?

[Fingerscrossed38]

If I had a chemical whilst on 75mg baby aspirin would going onto Clexane/ Heparin be of any use? Would you still continue with baby aspirin alongside the others? Apparently a TEG blood clotting test revealed my blood clots slightly quicker than average...

[mary77777]

I had a mix. I have something mild, not a big problem.

Initially, they started me on baby aspirin. After the pregnancy was confirmed, I went again to the hematologist who said I am fine (false thrombosis) and should not take anything. When I switched doctors (from ivf to regular), they put me again on baby aspirin as my uterine blood flows were a bit high (pre-eclampsia risk). After more checks, they said baby was a bit small, so to avoid issues I was told to also take clexane (and continue with baby aspirin). A few weeks ago (I am 35 weeks now) I was told to stop baby aspirin and continue only with clexane.

From what I read, baby aspirin stays longer in the body after the treatment is stopped, while clexane has a shorter time.

[Fingerscrossed38 in reply to mary77777]

Congratulations on your pregnancy! You're so close now!

Can I ask when exactly you started clexane and what dose?

My Dr didn't have any issues with baby aspirin so now I'm scared to take it. Maybe I should not have it and just stick to clexane on its own for the first few weeks? Did those studies say baby aspirin harmed pregnancy in women who had blood clotting issues or only those that took it when they didn't have blood clotting issues? So hard to know...xx

[mary77777 in reply to Fingerscrossed38]

My Dr told me to take both for a period and I read online that there are also others doing this.

I started taking baby asprin right after transfer (so there was no issue with implantation in my case) and my current Dr increased my dose after the pre-eclampsia risk.

With clexane I started at 25 1/2 weeks due to baby being small in my Dr opinion; I started with 4000iu (0.4ml) and from what I read it depends on body weight and my Dr asks me periodically how much I weigh so as to know if she needs to up my dose (I am underweight and even now I am around 117 pounds; still using the same dose of clexane). From what she told me, I will need to take clexane until 4-6 weeks after birth.

A friend of my is also pregnant (naturally, after trying ivf and iui). She did clexane also during part of her ivf treatment and is continuing now that she is pregnant. Her Dr told her that after birth she will probably take baby aspirin.

xx

[Fingerscrossed38 in reply to mary77777]

Very interesting. Thanks so much for the detailed response. It's wonderful news you're doing well xx

[Caroliono4]

Hi I'm sorry to hear of your chemical pregnancy.

I've also had recurrent miscarriage and was advised by my consultant not to take low dose aspirin as in some cases it can affect implantation, so I'd look to your consultant to guide you in this decision and make sure they have also tested your bloods for Prothrombin and Factor V Leiden gene mutation, which can affect clotting.

I have the Prothrombin mutation and have taken Clexane prior to treatment, which was upped by my consultant when I got to 28 weeks. I'm also taking 75mg aspirin, however the aspirin is to minimise chance of pre-eclampsia.

[Fingerscrossed38 in reply to Caroliono4]

Hi thanks for replying. When exactly did you start cleavage and baby aspirin and how much clexane? It seems likely I'll be on clexane next time. I just wonder why the baby aspirin want enough to thin the blood if I my blood clots to quickly...Surely the aspirin along should have sorted that? Is it still classed as an implantation issue if it's implanted and ends in chemical?

I don't know if I've had those tests done. I had the normal thrombophilia and antiphosphilipids mthfr tests done and all came back normal. Just had the TEG & Pai-1 blood test and awaiting pai-1 results. My TEG results show my blood does clot too quickly so I'll need clexane.If pai-1 do come back positive they'll be putting me on clexane for that too anyhow. So is there any point in doing those tests if I'll be defaulting to clexane regardless in my next transfer?

Do you also stay on clexane for a while post pregnancy? I read other women have but for how long?

[Caroliono4 in reply to Fingerscrossed38]

Hiyah. The first two times I took it were natural pregnancies and recurrent misc clinic prescribed clexane or similar (tinzaparin, inhixia) at 6 weeks after confirming pregnancy by scan. For ivf treatment I've started immediately after transfer, 2000iu per day. This was doubled to 4000iu at 28 weeks. I'll have to continue after birth but not sure how long.

With the aspirin, I started taking after my first antenatal appointment with consultant c. 10 weeks.

[Fingerscrossed38 in reply to Caroliono4]

Ok good to know. Thanks so much for the tips xx

[Hidden]

Hey, I have prescribed both - my bloods came back with clotting issues so I am prescribed Fragmin injection (1 daily) from ET and 75mg aspirin from any BFP x

[Fingerscrossed38 in reply to Hidden]

Ok good to know. Is fragmin the same as clexane/Heparin do you know? What dosage?

[Hidden]

Hi I think its Heparin, and I was given the 2000ml one. But not wishing to state the glaring obvious but everyone is different. My clotting was bad enough for them to say they would suggest I inject when I do long haul flights so its clearly quite dramatic. There are other doses (I think 1000ml) of the Heparin available. Surely your consultant should be able to advise on that? You sound a bit like you are self prescribing!? x

[Fingerscrossed38 in reply to Hidden]

Thanks. No not self prescribing just gathering Intel as it were. I feel like I'm directing my clinic at the moment. We did all the routine blood clotting tests and after I had another miscarriage and this time with a pgs normal embryo I insisted on more blood tests. One has come up with a slight clotting issue so I am just double checking what other girls are on so I can question them if I have to. I've got trust/control issues! I've picked up various mistakes with medication etc so feel like I have to double check everything now. Glad they'd discovered yours. Which tests did you have to discover your blood clotting issue?

[Hidden in reply to Fingerscrossed38]

I totally understand - half the time I feel like I know more from on here than my consultant does, and 99% of the time he dismisses stuff I suggest anyway!

I don't know what test they did.. it was a routine NHS blood test and they took 8 vials and did 8 tests. When my tests came back they said I had 'shown positivity to Lupus anticoagulant, anticardiolipin antibodies and Beta 2 glycoprotein' and consequently would be put on Fragmin from ET and Aspirin from BFP.

I felt like these tests were a big deal but no-one has said anything more about them and I wasn't offered steroids or anything else. I've just had my 3rd MMC at 5+6 and I am wondering if they should be doing more tests (also had at least one chemical) but they aren't offering me anything else. I think maybe because I am 42 they just think its poor egg quality.. I don't know what to think anymore!!

Masses of luck to you xx

[Fingerscrossed38 in reply to Hidden]

Oh gosh I'm so sorry you've had to experience another loss. It gets worse every time.

I know what you mean about wanting to do more and more tests. I hate it when Drs dismiss our suggestions and are less open minded. Surely there is a reason for the multiple losses and it can't all be bad luck! Were they pgs tested? I know that pgs testing doesn't eliminate every defect but it's helpful. So frustrating. Hang in there, you'll get there xx

[Hidden in reply to Fingerscrossed38]

Sorry didn't mean to make this post about me!! No they havent offered PGS testing so we keep blindly going on!! Hope your lot are a bit more proactive and you have a happy and successful pregnancy next time round xx

[Fingerscrossed38 in reply to Hidden]

Not at all! We are all here to cheer each other on. We will all get there in the end. 💛

[Cinderella5]

I get told to start on Aspirin 75 at the beginning of my cycle on an FET. I then get swapped onto Clexane 3 days before transfer and stop the aspirin so no I dont take them together. This is all on my treatment plan from my clinic and is all to help with blood flow to my uterus and I also had a slight increased risk of clotting on bloods.xx

[Fingerscrossed38 in reply to Cinderella5]

Ahh interesting. Can I ask what dose of clexane you're on each day?

What date is your next FET? Is this month right?

[Cinderella5 in reply to Fingerscrossed38]

Im on 40mg of clexane (Inhixa or Enoxaparin is the same thing too) in the evenings. Yes Im starting my FET this month....hopelly AF should arrive next week so not long now! How are you doing? How long until you get your ERA results back?xx

[Fingerscrossed38 in reply to Cinderella5]

Ok that seems to be the same dose most of the girls are on. I'll have a consultation with my Dr next week or the week after hopefully to discuss my new protocol and all the results.

My cycle should start any day now so FET should be around 23-25th October but we'll see what happens. I'll postpone it if my results are not back in time.

I'm sure you're feeling excited to be nearing FET time...xx

[Cinderella5 in reply to Fingerscrossed38]

Oh that's not too long to wait for your results. It would be good to hear how you got on....if they discovered anything. Hoepfully they will have a plan for you soon if you are due soon.

We are hoping to have embryo transfer 31st October so yes, nervous, excited and scared all at the same time!!xx

[Libsie3103]

I'm on long term Clexane (due to blood clotting issues not baby related) and I asked my Consultant the same question yesterday. He said that there is evidence and research to suggest Clexane and baby aspirin should be used in case of recurrent miscarriage as it can help.

I also chatted to my IVF Consultant who used to work in Obs / Gynae and he said that it's important not just to take both but to have it prescribed / advised. They are obviously concerned for the baby but also your health is really important.

[Fingerscrossed38 in reply to Libsie3103]

Thanks. The NHS recurrent miscarriage Dr I saw almost 2 years ago prescribed 75mg bay aspirin routinely. So my current Dr added on it because the other Dr had prescribed it. I'm not sure he would have bothered if the other Dr hadn't. He didn't seem phased either way which is odd but back then I didn't have any clotting issues and only find out a few days ago through the TEG test that is only done through St Mary's hospital that I had a slight clotting issue. Hopefully the Pai-1 test results that come back late next week will shed more light on my new protocol. Thanks again for your tips xx

[Libsie3103 in reply to Fingerscrossed38]

No problem, I've not looked myself but someone (reliable!) told me there are NICE guidelines on the use of Clexane in pregnancy. Not sure if that will mention aspirin as well or not xx

[Siyami12]

Hi ladies , it's been long I took part in any conversation here, I think I now know a little about the subjects often presented as I am almost ready for 2x blastocyst on Thursday,

All thanks to you all amazing ladies for your wonderful advices.

I was prescribed baby aspirin 75mg 2 cycle before my transfer date. My dr added claxane 0.4 to my prescription 5 days to my transfer. I don't have any blood clotting issues

Dr advices aspirin and clexane are to help tining blood for easy flow in to the womb in order to facilitate implantation and equally avoid miscarriage

I am 42 so dr adviced for 2 blastos transfer to maximise preg chances. It's my first cycle and self funded, am so so nervous

Congratulations to all those pregnant and courage and baby dust to those who are still in the journey

Fingers crossed for us all

[Fingerscrossed38 in reply to Siyami12]

How exciting! Best of luck with the transfer xx

[Siyami12]

Thanks fingerscrossed38