Low protein C

I had 4 times miscarriage (I have PCOS) and found out that I have low protein C with heterozgous Factor V Leiden. My doctor has advised me to take clexane 20mg with 75mg aspirin when I get pregnant next time. In Feb 09 I got pregnant and treated with cleaxane, aspirin and cyclogest but I had miscarriage last night. I am not sure what to do. Could you please advise me?

Thank you

[John Kim, M.D.]

I am sorry about your miscarriages.
I presume that you had a complete work up for your miscarriage like the following from my website:
Recurrent pregnancy loss can be attributed to many different causes. These causes include: genetic factors (e.g. abnormal fetal chromosomes, abnormal parental chromosomes); anatomic factors (e.g. structural abnormalities of the uterus such as scar tissue in the uterus, or congenital abnormalities of the uterus such as septate uterus); metabolic factors (e.g. diabetes); endocrine factors (e.g. abnormal thyroid, PCOS, diminished ovarian reserve); infectious factors (e.g. chlamydia, mycoplasma, ureaplasma); thrombotic factors (e.g. inherited thrombophilias); immunologic factors (e.g. anticardiolipin antibodies, autoimmune disorders, increased natural killer cell activity); male factors (e.g. sperm DNA fragmentation); and environmental factors (e.g. exposure to environmental toxins).

If the only finding were the low protein C and heterozygous for factor V leiden, then your treatment with baby asprin (81mg in the U.S.) and low molecular weight heparin is appropriate next time as your doctor suggests

I presume with a history of PCOS that you are on fertility treatment too and have adequate luteal phase support with good progesterone levels.