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Fertility / Infertility (Expert Forum)
Would you add Heparin or Lovenex(sp?) to my treatment?
Questions in the Fertility/Infertility forum are answered by doctors affiliated with USF Health. Topics covered include fertility or infertility issues, egg quality, fertility drugs and side effects, fertility tests, genetic testing, in-vitro fertilization (IVF), ovulation, relationship issues, risk factors, sperm count/quality, and surgery.
Would you add Heparin or Lovenex(sp?) to my treatment?
by dainsey, Mar 04, 2007 12:00AM
Hi there,
I have been indentified as having the MTHR gene, yet my homosystene isn't elevated. I had one RE tell me that taking Folgard, baby aspirin and high amounts of folic acid are enough. Yet, another RE told me that since 2 cop[ies of a mutation were identified, it's a compounded problem and I should be taking either Heparin or Lovenex (sp?)?? What do you feel is best?
Thank you!
I have been indentified as having the MTHR gene, yet my homosystene isn't elevated. I had one RE tell me that taking Folgard, baby aspirin and high amounts of folic acid are enough. Yet, another RE told me that since 2 cop[ies of a mutation were identified, it's a compounded problem and I should be taking either Heparin or Lovenex (sp?)?? What do you feel is best?
Thank you!
Doctor's Answer
by USF-M.D.-DK, Mar 04, 2007 12:00AM
dainsey,
two variations of the gene for MTHFR exist in the population. one is so common (about one in four people carry it), and has so little effect on the function of the body, it should be thought of as a normal variation. if you have even two copies of this variation, with a normal homocysteine level, take no action. the other genetic variation more commonly affects the function of the molecule and elevates homocysteine levels. homocysteine is a molecule typically found only in low levels in the body, which at high levels, e.g. from the pathogenic MTHFR mutation, can irritate the lining of blood vessels and trigger blood clotting and cause miscarriage. the first line treatment for MTHFR mutation associated with elevated homocysteine is to take high doses of folic acid, which will drive down homocysteine levels. some doctors believe this may be enough to fix the problem. others prefer to add baby aspirin and low dose heparin, a blood thinner, to make sure the blood does not clot. baby aspirin and heparin, like any medication, have their own risks and side effects. there is no consensus among specialists which is the correct approach. if one has the pathologic MTHFR mutation and normal homocysteine levels, it is unclear whether the benefits of treatment outweigh risks. some doctors believe the pathologic MTHFR mutation may disrupt pregnancies without affecting homocysteine, while other studies have not born this out. in this case, i tend to treat with folic acid 4 milligrams per day, since this should be safe. david
two variations of the gene for MTHFR exist in the population. one is so common (about one in four people carry it), and has so little effect on the function of the body, it should be thought of as a normal variation. if you have even two copies of this variation, with a normal homocysteine level, take no action. the other genetic variation more commonly affects the function of the molecule and elevates homocysteine levels. homocysteine is a molecule typically found only in low levels in the body, which at high levels, e.g. from the pathogenic MTHFR mutation, can irritate the lining of blood vessels and trigger blood clotting and cause miscarriage. the first line treatment for MTHFR mutation associated with elevated homocysteine is to take high doses of folic acid, which will drive down homocysteine levels. some doctors believe this may be enough to fix the problem. others prefer to add baby aspirin and low dose heparin, a blood thinner, to make sure the blood does not clot. baby aspirin and heparin, like any medication, have their own risks and side effects. there is no consensus among specialists which is the correct approach. if one has the pathologic MTHFR mutation and normal homocysteine levels, it is unclear whether the benefits of treatment outweigh risks. some doctors believe the pathologic MTHFR mutation may disrupt pregnancies without affecting homocysteine, while other studies have not born this out. in this case, i tend to treat with folic acid 4 milligrams per day, since this should be safe. david
