lovenox and mthfr gene

[Anonymous]

Anonymous wrote:To pp 15:27

Thank you for taking the time and answering my questions.
Did you do ivf or natural?
And if natural how long did it take you to conceive?

PP here. I did natural too and got pregnant the first cycle! (Which was great since paying Dr. Braverman to monitor your cycle out of pocket is not cheap). My prob has never been getting pregnant, just staying pregnant.

Wishing you lots of luck!

[Anonymous]

Other Dr. Braverman patient here and I just have a question... did you have any HLA matching issues? I'm the only other person I know of who succeeded with Neupogen with out having HLA issues. Did he give you a diagnosis? I have my theories but nothing definite.

[Anonymous]

I took a it's of vitamins, saw hamersey and took baby aspirin. She will also recommend mega doses f frolic acid and a special prenatal vitamin. She's great! This was my healthiest pregnancy and delivery. I have mthfr and had 3 pregnancy loses. Mi did not take lovenx just the above mentioned. Mi also ate organic and only drank filtered water.

[Anonymous]

My issue was failed IVF implantations. Testing revealed homozygous MTHFR and PAI-1. So for my next (and successful) IVF cycle and subsequent pregnancy, I was on Lovenox and baby aspirin. Once I was released to an OB, I did prenatal care with the high risk team at Georgetown and that included monitoring by hematologist. The hematologist was great, but her being at Georgetown meant that I (and my insurance) were charged double co pays (one for her and one for the "facility", a total ripoff), and doing office visits in the Lombardi Cancer Center, where the hematology department has their offices and I did not enjoy that at all. It also meant having residents tag along but I didn't mind that so much. Insurance covered the Lovenox with a copay. She took me off Lovenox at about week 34.

Incidentally, for the initial evaluation of the failed IVF implantations, I met with a doctor in NYC, Dr. Orli Etingen, at a friend's suggestion. Dr. Etingen made the medication protocol recommendations to my IVF doc who incorporated them in my next cycle.

[Anonymous]

Anonymous wrote:My issue was failed IVF implantations. Testing revealed homozygous MTHFR and PAI-1. So for my next (and successful) IVF cycle and subsequent pregnancy, I was on Lovenox and baby aspirin. Once I was pregnant and released to an OB, I did prenatal care with the high risk team at Georgetown and that included monitoring by hematologist. The hematologist was great, but her being at Georgetown meant that I (and my insurance) were charged double co pays (one for her and one for the "facility", a total ripoff), and doing office visits in the Lombardi Cancer Center, where the hematology department has their offices and I did not enjoy that at all. It also meant having residents tag along but I didn't mind that so much. Insurance covered the Lovenox with a copay. She took me off Lovenox at about week 34. I delivered in a planned C-section (due to prior abdominal surgery) at week 39. All well.

Incidentally, for the initial evaluation of the failed IVF implantations, I met with a doctor in NYC, Dr. Orli Etingen, at a friend's suggestion. Dr. Etingen made the medication protocol recommendations to my IVF doc who incorporated them in my next cycle.

PP here -- forgot to mention that my protocol included big doses of folic acid -- 4 MG/day, which I continued until I stopped breastfeeding. The hematologist recommended a lifetime dose of 1 mg/folic a day.

[Anonymous]

To pp
Can you tell me about your labor and delivery? When you went off lovenox at 34 weeks, did you switch to heparin?
I just started lovenox and aspirin as soon as I got a bfp, I conceived naturally. I am borderline, so I am on lovenox as a precaution.
I do have some concerns about going into labor and the lovenox is still in my system? I can not have an epidural with lovenox.

I was also thinking about consulting with a hematologist in Georgetown, who did you see?

Btw- I think Dr. Etingin is very smart and so nice. I used to work with her about 10 years ago. She was also my pcp.

[Anonymous]

Anonymous wrote:To pp
Can you tell me about your labor and delivery? When you went off lovenox at 34 weeks, did you switch to heparin?
I just started lovenox and aspirin as soon as I got a bfp, I conceived naturally. I am borderline, so I am on lovenox as a precaution.
I do have some concerns about going into labor and the lovenox is still in my system? I can not have an epidural with lovenox.

I was also thinking about consulting with a hematologist in Georgetown, who did you see?

Btw- I think Dr. Etingin is very smart and so nice. I used to work with her about 10 years ago. She was also my pcp.

Either they will switch you to heparin at 34 week, which has a much shorter half like so can leave your system in time for delivery. Or they will schedule an induction and you will stop the lovenox 24 hours before.

[Anonymous]

Anonymous wrote:Other Dr. Braverman patient here and I just have a question... did you have any HLA matching issues? I'm the only other person I know of who succeeded with Neupogen with out having HLA issues. Did he give you a diagnosis? I have my theories but nothing definite.

I am 14 weeks on neupogen with Braverman with no HLA matches.

[Anonymous]

Anonymous wrote:To pp
I was also thinking about consulting with a hematologist in Georgetown, who did you see?

Btw- I think Dr. Etingin is very smart and so nice. I used to work with her about 10 years ago. She was also my pcp.

The hematologist at Georgetown was Dr. Broome. She was great -- very supportive.

[Anonymous]

Anonymous wrote:To pp
Can you tell me about your labor and delivery? When you went off lovenox at 34 weeks, did you switch to heparin?
I just started lovenox and aspirin as soon as I got a bfp, I conceived naturally. I am borderline, so I am on lovenox as a precaution.
I do have some concerns about going into labor and the lovenox is still in my system? I can not have an epidural with lovenox.

When hematologist took me off Lovenox at 34 weeks that was it -- no heparin. I had a planned C-section (due to prior abdominal surgery) and I did not go into labor before the day we delivered (week 39) so I didn't have those concerns and we did not discuss.

[Anonymous]

Anonymous wrote:

Anonymous wrote:To pp
I was also thinking about consulting with a hematologist in Georgetown, who did you see?

Btw- I think Dr. Etingin is very smart and so nice. I used to work with her about 10 years ago. She was also my pcp.

The hematologist at Georgetown was Dr. Broome. She was great -- very supportive.

Ok, I was thinking of either her or Dr. Kressler.

[Anonymous]

I can also highly recommend Dr. Hamersley. After multiple miscarriages, I was treated with Lovenox for a clotting disorder. I was also heterozygous for MTHFR. Took baby aspirin as well. I received wonderful prenatal care and can't say enough good things about "Dr. H." I now have two healthy children, and she played a big role in making that possible. Best wishes to you on your own parenthood journey!

[Anonymous]

Anonymous wrote:I can also highly recommend Dr. Hamersley. After multiple miscarriages, I was treated with Lovenox for a clotting disorder. I was also heterozygous for MTHFR. Took baby aspirin as well. I received wonderful prenatal care and can't say enough good things about "Dr. H." I now have two healthy children, and she played a big role in making that possible. Best wishes to you on your own parenthood journey!

I actually did see Dr. Hamersley for a consult prior to getting pregnant. She is wonderful. I will probably see her intermittently through out my pregnancy. Was she your main ob or did you just consult with her? She's too far from me, so I have to stick with my ob in nova.

[Anonymous]

I'm not the PP but I recommended her as well. I see her in addition to my regular OB. My OB will deliver me, but she monitors growth etc since I am considered high risk after having so many losses. She has great communication with my OB's office and they get all of her recommendations through their electronic system so I don't have to worry about remembering everything.

[Anonymous]

Hi, can someone tell me if the MFM you see needs to have privilege at the hospital you want to deliver in? I think I want to deliver in Inova Loudoun but I don't really like the MFM practice in this area (MidAtlantic MFM group). I think I may go to Inova Fairfax since they have a NICU and they have the facility to handle really high risk PG's.

I have compound MTHFR mutations and +APA and will be taking folgard 2.2 and baby aspirin. I am hoping my RE will let me use lovenox/heparin when I start my DE cycle. Has anyone taken steroid (prednisone or medrol) when TTC?

Thank you.