Q&A: I want to carry a baby, but I have Anti-phospholipid Antibody Syndrome.

by Dr. Randy Morris

I have Anti-phospholipid Antibody Syndrome, and have already suffered through three miscarriages. Is there anything in particular I can do to help increase the likelihood of carrying a fetus to term? Does having this medical condition prevent me from using fertility drugs?

Recurrent miscarriage (RSA or recurrent spontaneous abortion) affects 1 percent of couples attempting to have a baby. The vast majority of these are caused by fetuses with chromosomal abnormalities. There are multiple other causes for RSA including the Anti-phospholipid Antibody (APA) Syndrome. To make a diagnosis of APA syndrome, women must demonstrate both clinical signs such as arterial or venous blood clots and/or fetal loss and laboratory signs. Laboratory signs include elevated levels of anti-cardiolipin (ACL) antibodies, beta-2 glycoprotein, or lupus anticoagulant (LAC).
The frequency of APA syndrome is unknown. One to 5 percent of healthy individuals may have elevations in ACL or LAC antibodies. The rate in women with infertility may be 15 to 20 percent. These women do not have APA syndrome.
Several studies have now shown that treatment of women with low-dose aspirin plus an injectable anti-clotting medication (Heparin or Lovenox) is successful at reducing the risk of miscarriage.
APA syndrome does not preclude women from also using other types of fertility treatments including fertility drugs.

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