Apparently, I have antibodies in my blood called Antiphospholipids (PHOSPHATIDYLSERINE AB (IGG)).
Two months after my loss, I visited my IVF doctor because I needed answers. The pathology report returned, reporting negative chromosomal abnormalities and no congenital anomalies. So was there something wrong with me? Was I the cause of us losing our child?
There was a mixture of special and terrible memories when returning to the IVF office. I had a sick feeling in my stomach from having to return so soon. I expected my next visit to be for a second transfer and having 2 healthy babies.
The Doctor completed a vaginal ultrasound to ensure that the D&C procedure did not cause any damage to my uterus. He reported it is rare, but there have been some cases where scarring will occur inside the uterus, leading to infertility if not removed correctly. Good news, no scarring. We then proceeded to his office, and he suggested having some blood work done to rule out any conditions.
The Medical Assistant thought it would be a good idea to say, “I didn’t think I would see you back so soon.” Well, honey, I DIDN’T THINK I WOULD BE BACK HERE SO SOON EITHER! Tears would run down my face while explaining what had happened to me. He suggested that we probably shouldn’t try another transfer just yet due to my mental condition. I agreed a 10000%; there was no way I could do a transfer just 2 months after losing my first child. I knew I wasn’t ready yet.
My bloodwork returned, and I was diagnosed with a specific Antiphospholipid syndrome, PHOSPHATIDYLSERINE AB (IgG). According to my IVF Doctor, this antibody causes blood clots in your placenta.
According to Hospital of Special Surgery they define Phosphatidylserine AB (IgG) as, “A systemic autoimmune disease characterized by production of antibodies – that “attack” the person’s own body, resulting in blood clots and/or pregnancy complications. However, people who are aPL-positive, that is, those who produce aPL, may or may not develop clinical problems. A positive aPL test is not enough to diagnose APS.”
There are two criteria you would have to meet to fit this condition. The first criteria would be a medical history of blood clots or pregnancy complications, including multiple miscarriages. The second criteria are clinical, testing the patient’s blood multiple times (at least twice and 12 weeks apart) and receiving multiple positive results.
I met with a Hematologist for a second opinion. The Hematologist stated that technically I do not meet the full criteria of ASP due to only having 1 miscarriage. He reported they mainly diagnose individuals who have had multiple miscarriages and multiple positive blood tests.
So say I do have Antiphospholipid syndrome, would this lead me to have another miscarriage?
Per my IVF doctor, there is a 70% chance of having a full-term pregnancy if I inject my belly every day with a low heparin injection (an anticoagulant, a medication that assists with preventing blood clots), as well as a baby aspirin daily during the pregnancy and 6 weeks after to prevent blood clots. He reported having written a study on this condition.
Per my Hematologist, there aren’t enough studies that state heparin injections will make any difference in a full-term pregnancy, but it doesn’t hurt to try.
Do you see where I become frustrated and annoyed? Two doctors, two different fields with two different experiences and responses. They both want to help, but who do you believe? Who do you trust? Is 70% still enough of a percentage to try again? I battle with these questions daily.
References
“Top 10 Series: Antiphospholipid Syndrome (APS) and Pregnancy.” Hospital for Special Surgery, 7 June 2019, https://www.hss.edu/conditions_top-ten-antiphospholipid-syndrome-pregnancy.asp.
