Anonymous wrote:I'm currently 16 weeks pregnant and like one of the PPs I conceived on Neupogen (naturally and on the first attempt) prescribed by Dr. Braverman after I miscarried twice with IVIG. I started lovenox and Neupogen at the same time, right after ovulation.
I am on lovenox for PAI-1, MTHFR, and FVL (also elevated APS, but not diagnosed with APS). I also see Dr. Hamersley who has FVL and has also had miscarriages (I've had 8). My insurance had no problem covering lovenox with my specialty med co-pay. I'm guessing it's because I have FVL though. They ship me 3 months at a time along with sharps containers and alcohol swabs.
MTHFR itself does not cause a problem itself like another PP mentioned, but many REs will treat with lovenox empirically if they uncover something with your RPL panel. You could also have something else undiagnosed that lovenox will treat, especially if you have not been tested for immune issues.
Dr. Hamersley is great and so is Dr. Braverman

Anonymous wrote:To pp17:09
Did you take anything else for your immune issues?
At what point did you start taking lovenox?
I have to take it 3 days after an LH surge using a OPK, I am ttc naturally.
Anonymous wrote:Regardless of if you take lovenox or not, be sure you take Metanx- a prescription strength folic acid. With the MTHFR gene, your body has a hard time converting folic acid into its usable form, L-methylfolate. Metanx is folic acid already in the L-methylfolate form so your body can absorb it. Taking extra regular folic acid does not help. Many doctors will prescribe a similar prescription strength folic acid, Folgard, but anyone who really specializes in this says that Metanx is definitely the way to go. Without it, you run the risk of increased down syndrome and other neural tube defects (there have also been some recent studies showing a link between MTHFR and autism if not properly treated during pregnancy). Insurance usually doesn't cover it and its like $60 a month. In case your doctor hasn't prescribed it, definitely ask them to!
My insurance covers my lovenox and I also take a baby aspirin among other things. I have MTHFR plus one other blood clotting disorders plus immune issues. (Often immune issues and blood clotting disorders come hand in hand). Lovenox helps both because it is an anti-inflammatory and when you have immune issues, your body will send small blood clots to kill the fetus- something that is made easier when you have a blood clotting disorder.
After your two losses, I wouldn't take the risk and would go ahead and use the lovenox. It can help so much with implantation issues which could likely be the cause of your early miscarriages. You might only need it for the first trimester and if you do need it throughout the pregnancy, some doctors switch you to heparin in the last month- which leaves your body quicker so you can still do an epidural or will schedule you for induction and you stop the lovenox 24 hours before delivery.
A high risk OB who specializes in blood clotting disorders in the area is named Dr. Hamersely. She is based in Rockville with Maternal Fetal Medicine Associates of Maryland. She accepts most insurance so you may want to get a second opinion from her. She is one of the top specialists in blood clotting disorders in pregnancy in the country and writes most of the standard protocols.
Anonymous wrote:Anonymous wrote:I took blood thinners for PAI-1 and anti-phospholipid antibodies. Also tested heterozygous for MTHFR, but my doctor considered that a minor issue. It was covered by insurance with a small co-pay and I took it from 2 weeks pre-transfer to 6 weeks post-partum.
Did you get an epidural?
Anonymous wrote:I took blood thinners for PAI-1 and anti-phospholipid antibodies. Also tested heterozygous for MTHFR, but my doctor considered that a minor issue. It was covered by insurance with a small co-pay and I took it from 2 weeks pre-transfer to 6 weeks post-partum.