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Introduction and questions
Hi! My name is Tracie. I am 32 years old DH and I have one four year old boy. We got pregnant on the first try with him. He had one of the worst cases of reflux I have heard of, and even though we had always wanted two children, we decided we couldn't handle another baby like he was and a toddler. Last summer we got pregnant by accident. :). Six week u/s looked good. I started bleeding at ten weeks. U/s confirmed fetus stopped growing at six weeks three days. We had gotten attached to the idea of another baby and decided to try again. We got pregnant on our first try. Six week u/s looked good. Nine week ultrasound showed fetus stopped growing at eight weeks. I went to RE who ran every test imaginable. Anticardiolipin antibodies showed up positive by a point or two. RE sent me to hematologist who retested and ran a more specific test and both came back negative. He said ACLs that go in and out of positives are nothing to be concerned about - only the ones that stay positive cause issues. He said I could do lovenox injections if I get pregnant again, but it is likely unnecessary. Oh, and my SED rate is always high - it is typically and indicator of an infection or inflammation, but neither my gp, a rheumatologist, nor a hematologist could figure out why.

RE wants me to do 2.5mg letrozole for five days of a closely monitored cycle to ensure a healthy egg when we TTC again. My cycles are always regular, and all of my relevent tests were normal.

I recently heard about specific gene testing for MTHFR. I had previously read about it and that homocysteine levels were a good indicator of the mutation. At the time of testing a month after my second miscarriage, my homocysteine level was normal.

My questions - does anyone know of any studies or have any experience with perfectly fertile couples who take letrozole - specifically with regards to multiples?

Is there anything else I should be doing before or during TTC to ensure a successful pregnancy?
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Here is the rest of my question.

I mentioned to my RE about testing for MTHFR but he said since I had a single positive test for anti-cardiolipin antibodies, he would treat me with lovenox anyway so any further diagnosis was unnecessary. I had already asked my gp to run the test, and I got the results the other day. I tested positive for the heterozygous mutation of c677t. The a1298c was normal. From what I have read, treatment is not indicated with that particular mutation, is that true? Im apparently going to be having lovenox injections anyway, so I guess that part is irrelevant, but what about additional folic acid? This next try is going to be our last, so I want to make sure all of my bases are covered.
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