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Posted by: Natasa74

Dear doctor,

I’m seeking your opinion on my condition. I am 40 and have been trying to get pregnant for the past 5 years. So far I’ve been pregnant several times. One of my pregnancies was terminated at week 18, due to the meningoencephalocele. I had three miscarriages, and several chemical pregnancies. Analysis of our chromosomes were fine. Cervical swabs were fine (done them twice). I have a thrombophillia but heparin 2500 treatment did not prevent the pregnancy to stop developing. Cardiolipin antibodies are borderline positive. A mild septum has been removed by hysteroscopy. My TSH is normal, my blood type is 0 negative and my husband’s is 0 positive. Sperm analysis is normal. I also have a 3 cm subserous myoma. I am a chemist by profession and am prepping for an IVF and I wonder if I have anything to hope for.

Sincerely yours, Nataša.

Answer by: Romana Dmitrović, MD, Ph.D.

Dear Nataša,

I am truly sorry you had to go through all of this. It is obvious you get pregnant easily, but along with your trombophillia and antiphospholipid syndrome there has to be something else that is wrong because your miscarriages happened at different stages of your pregnancies. It could be your hormones, OGTT, antisperm antibodies or something else. The only way for you to know that a healthy embryo has been implanted in your uterus during the IVF (which can then be helped by heparin therapy, taking corticosteroids or such) is to do the PGS (pre-implantation genetic screening). Unfortunately, it is not being done in Croatia so we have to send our patients abroad. Without the PGS, IVF or ICSI can be used to choose a morphologically best embryo which can help you, but not necessarily has to do so.

Wish you all the best,

Romana Dmitrović, MD

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