Posted by: zubari

Dear doctor,

After two failed pregnancies (a 9-week spontaneus one and an 11-week IVF one) I have the thrombophillia screening done. The results were as follows: factor V Leiden normal, Factor II prothrombin normal, MTHFR C677T – heterozygous, PAI heterozygous 4G/5G. In your opinion, do I qualify for heparin therapy and if so, when should I start the therapy since I’m planning another IVF? There is family history of thrombophillia, diabetes and two strokes that my mother had and my father had a stroke and died two years ago. Thanks in advance. 

Answer by: Romana Dmitrović, MD, PhD

Dear zubari,

According to all relevant literature, thrombophillia screening results are not an indication for heparin therapy immediately after IVF, because it doesn’t help implantation. Only after fetal heartbeat has been established and combined with an opinion of a hematologist or fetal medicine specialist, it is possible to include heparin therapy in the treatment. Considering your medical history, I’d suggest you contact a hematologist or fetal medicine specialist to get their opinion in writing before you proceed with the IVF cycle. However, should they recommend heparin therapy, you have to be aware that miscarriage can still occur while on therapy. Your test results for trombophillia may simply imply your chances for future development of some of the conditions mentioned in your family history.

Best regards,

Romana Dmitrović, MD