chemical pregnancy and clexane dose

[suzans]

Hi all, this is my first post here, I had 5 chemical pregnancies and I've never had a successful pregnancy before, I have blood disorders 'sticky blood' and more than one doctor has put me on 40 mg clexane on my 3rd and 4th pregnancy, and on my 5th pregnancy I had 60 mg clexane but all ended the same way (chemical).

Now my new doctor is telling me that I absolutely needed 80 mg clexane and that is the reason for my chemicals!

I have all the RPL tests done and I don't have other problems than this, I am a 'diabetes' but it is good controlled so the doctor said it is not the cause.

My question is that I am not convinced with what the doctor is saying, because if it is just the clexane dose, so why all my pregnancies doesn't last for at least few weeks? could the clexane dose affect all my pregnancies that early!

Is there anyone had this situation and have been told this as me? what was your clexane dose for a successful pregnancy?

Thanks ladies....

[Elin85]

Hi, im so sorry for your losses i had like you 5 chemical pregnancies. After 4 of them they tested me for hughes syndrome and i was Lupus anticoagulant positive, so i have hughes syndrome(stickyblood). They gave me babyaspirin as soon as they found out and i started fragmin 5000 Units when i got a positive pregnancy test Thats equal to 40 mg clexane. Well that didnt work the first time i got pregnant after that, and i started looking for other answers and found out that prednisolone could work because My immunesystem was probably overactive. I started prednisolone

10 mg at ovulationday and Continued it to week 13 of pregnancy (tapering it down 2 weeks before). That worked and i am now pregnant in week 23 still on fragmin and aspirin! Talk to your fertilitydr about tv is, i really think It was the Prednisolone that finally helped me. Wish U all the best, Elin from sweden

[suzans in reply to Elin85]

Thank you Elin85 for your detailed reply, unfortunately, I've already tried prednisolone in my last try I started 25 mg at ovulation day! but it didn't make any difference, I also had progesterone pessaries and tablets but still had chemical! me and my doctor don't know what to do to make it work

[Esmes2013]

Hi I have had 4 early miscarriages and had no treatment for any of them. I had one positive test for "sticky blood" and one negative. Strangely enough I have been doing research and totally relate to Elin 85 reply. I am ttc now and will take 20mg prednisone from ovulation and 40mg clexane from bfp, baby aspirin also to see if it works. So happy it worked for you Elin 85! Good luck Suzans - I have raynauds and there are a lot of auto immune disorders in the family do am feeling positive now I have a protocol to try as its devastating to keep losing !!

[Elin85 in reply to Esmes2013]

I really believe its going to work for you esmes2013!! I Also have a lot of autoimmunity in My family! And me myself have endometriosis and hidradenitis suppurativa which is also autoimmune diseases, i really wish you the best of luck// Elin 

[suzans in reply to Esmes2013]

Thanks Esmes2013! wish you all the luck in your next try

[ema_35]

Hi, I am very sorry to hear of your loses - APS is such an unfair condition especially in pregnancy! Don't give up hope! I have had 2 successful pregnancy outcomes. With my daughter I was on 40mg clexane and baby aspirin but diagnosed late at 10 weeks pregnant after a suspected TIA. With my son I was given triple the dose (120mg clexane per day) plus baby aspirin and it seemed to help as he was a better weight and I made it further along in gestation. I have heard of women having the prednisolone with good outcomes also. Hopefully you can work with your doctors in getting the dose right for you.

[suzans in reply to ema_35]

Thank you ema_35! I am trying to not giving up hope, and I will try 80 mg clexane next try. but I cant help feeling worry all the time that nothing is working out for me, wish me luck.

[MaryF Administrator]

HI there, and welcome, I thought I had replied to you yesterday, but perhaps I had not loaded up my post. Sorry about your previous losses, this is the right forum for help. I also enclose, the list of recommended specialists: hughes-syndrome.org/self-he...

The right team will set the correct medication dose for your individual needs, and also look at your vitamin D, B12 and iron, plus a Thyroid panel, some woman also need progesterone, it is very important to ask the right questions and take somebody with you to support you at appointments, many on here have been in the same boat and will understand what you have been through and also your questions about the future. Best wishes. MaryF

[suzans in reply to MaryF]

Thanks MaryF for your reply, can I make online consultation? I am in the middle east and I can't have a real appointment and pay online for the fees?

[MaryF Administrator in reply to suzans]

I am not sure it can work like that in the UK, you may be able to do it in another country.  There is some knowledge I believe in Dubai.  

Prof. Munther Khamashta

Department of Rheumatology, Dubai Hospital, Dubai

  MaryF

[suzans in reply to MaryF]

Thank you Mary!

[Bravogirl16]

Hi its quite possible you can get skype consultation from private clinicians in the UK esp because you are overseas. Try and ring or email the secretaries of the clinicians listed in the link Mary has sent you. I sincerely hope and pray things work out for you. 

From my knowledge about chemical pregnancy, (from my personal experience) its a problem with implantation mainly, which could be due to various causes including chromosomal about which you can not do much. Given your recurrence, its quite possible that something might be a root cause which gives you better odds for success. Some women go on heparin or aspirin prepregnancy and some take steroids midovulation..and there are many other therapy regimes that clinicians try based on history. No one knows why one therapy works for some and not for others. Hope you get a detailed assessment soon so you can get on with ttc again for a successful pregnancy this time. In the mean time, hope you are watching your diet and weight etc. Loads of luck xx

[suzans in reply to Bravogirl16]

Thanks Bravogirl16 for your reply! can I ask you a question? my doctor has told me that once HCG has begun to exist in my body, that means that the implantation has occurred successfully, so how come that chemicals are mainly implantation problem? 

in all of my 5 chemicals, HCG begin to raise and doubling a couple of times then it begins to drop, I took aspirin+steriods+clexane+progestrone+ has been on 5 mg folic acid for 3 years now. but seems nothing is working out with me.

[Bravogirl16 in reply to suzans]

Hi Suzans, I'm not a specialist so you'd need a detailed assessment for the reasons behind your losses. From my own experience and detailed digging into reasearch, there can be multiple causes of early losses and without detailed info on your medical background including age, a lay person would think of common causes such as implantation failure esp in cases of chemical pregnancy. It might just be a case that you get hcg rise during the time when egg and sperm meets but they drop in quickly due to failure in successful implantation which can again be due to various reasons. One the quality of egg/embryo itself or the inner lining of uterus (endometrium) upon which embryo has to attach itself. Generally blood tests such as AMH level, D21 progesterone levels and an ultrasound scan for antral follicle count and endometrial thickness gives you a good idea about these. Quite often people also test themselves of things like MTHFR gene and NK (controversial though) when conventional tests have come back negative. As I understood from my consultant, high dose folic acid is needed only in specific cases, so no point taking it blindly unless you fall in that category but yes imp to take atleast 400 mcg folic acid. You seem to be under some specialist who is obviously thinking of covering all the basis by throwing all reknowned medications supposed to be helping in such cases. I would urge you to make contact with some recurrent miscarriage specialist with special interest in APS (they are there in the link above) so they can give you a clear plan for your future pregnancies. Good luck xx

[suzans in reply to Bravogirl16]

Thanks alot Bravogirl16 for your detailed reply I will try for sure to get a consultation with recurrent miscarriage specialist ASAP and hope that I can get a successful plan.

[Sev132]

I'm so sorry to hear about your losses. What a heartbreaking journey! I also have APS and have had four 1st trimester losses. Our last pregnancy was our longest. We got to 21 weeks but unfortunately placenta was riddled with clots and baby didn't make it I think we got that far last time because we upped my clexane to 100mg twice daily and I was on cartia (aspirin 100mgs daily). 

This time round ttc docs have me on prednisone, clexane, aspirin, extra folate, plaquinil, vitamin e, CoQ10, and I also do IVIg every three months (if I do get a bfp then I will have to continue IVIg every month til 36 weeks). Apparently this protocol has worked for a lot of ladies so I'm hoping this works for me. 

Hope this helps x

[suzans in reply to Sev132]

I'm so sorry for your losses Sev132! I wish you a very good luck on your next try, may I ask you why did he prescribed "plaquinil"? how would this help?