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Thread: Immunological Issues

  1. #1
    Join Date
    Jan 2010

    Default Immunological Issues

    Dr. Coulam,

    I'm a 32 year old woman who has been attempting pregnancy intermittenly for the past 3 years. I have a history of Common Variable Immune Deficiency..low IGG, IGA, and IGM(IVIG therapy every 3 weeks), rheumatoid arthritis(no meds except arthritis tylenol daily). In addition, I have been tested positive for lupus anticoagulant twice and thyroperoxidase antibodies were slightly high at 17.6...TSH has been normal demonstrating normal thyroid function. Also, a ultrasound prior to sonohysterogram was normal so the sonohyst was not performed. I have had 3 pregnancies in a row diagnosed with blighted development in the sac. The first two pregnancies I had NO prophylactic treatment as diagnoses of Lupus antigoagualtion and underactive thyroid had not been made yet. The third blighted ovum I just had I was on Prometrium support during luteal phase 200 mg once a day, 81mg baby aspirin once a day, extra folic acid, extra iron, prenatals, levoxyl 50mcg daily(had been on only 2 months prior to getting pregnant)and lastly started Lovenox injections 60 mg twice daily at 6 1/2 WEEKS OF PREGNANCY ..seems as though all of this did not help. My RE said he may try the Lovenox injections even earlier like post-ovulation (and Clomid while coagulating me to acheive pregnancy sooner than later). He thinks IVF would be a last resort to maybe get "the best eggs". My question's are: What would you do differently if anything at all if you were to help me acheive a pregnancy again for the 4th time. Does taking Lovenox that early make that big of a difference and could starting it that late in pregnancy make for a bad outcome? Would a steroid like prednisone be of benefit to me? Do I still have a chance since 3 pregnancies have turned out exactly the same? I desperately want to get this right and have the best chances for a healthy pregnancy. Thankyou for your time and knowledge Shawna

  2. #2
    Join Date
    Sep 2008


    I am sorry to hear of your difficulties. It is difficult to give adavice regarding specific patient management without benefit of evaluation and consultation. If you would like a consulltation, just call 847 869 7777 to make an appointment. This consultation may be done over the telephone if moe conveneint for you. You always have a chance for successful prenancy. We just need more information so that we can treat the cause specifically. Dr. Coulam

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