In Which the Anxiety Level Goes Up a Notch

I posted last week about my attempts to get my RE to start me on Lovenox at transfer rather than waiting for rising betas. With my history I want to give this my very best shot (ha!), but she has officially refused my third desperate plea. Three strikes and I’m out. I don’t see any way to prevail on this one.

She sent me an article saying heparin didn’t improve outcomes [Aspirin plus Heparin or Aspirin Alone in Women with Recurrent Miscarriage; New England Journal of Medicine; March 24, 2010] but as this article notes, there are all kinds of conflicting studies on this. Even though the cause of my pregnancy issues is unclear, I felt like we have enough clues here to justify aggressive action:

First Loss - Jeremiah (January 2007 at 21w 3d) cord hypercoiling

Moderate positive result on anticardiolipin antibody IgG; after six weeks this was retested and the level was "inconclusive"

From Pathology: “Received is placenta, umbilical cord, and fragments of blood clot and decidual tissue. Twisting of the cord appears abnormal, with more twists per centimeter than average. The placenta appears somewhat disrupted.”

Second loss: Miles (July 2007 at 18w 5d) cord stricture
Additional testing on me showed I am heterozygous for MTHFT mutation C677T

Lots of old blood in the amniotic fluid - not sure if there's any significance to this

I took baby aspirin during this pregnancy from 6 weeks onward

Anticardiolipin was normal this time

I do have two living children, a son born 2003 and a daughter in 2005. They also had placenta/cord issues, especially my son:

David (2003) - Lagging growth was first noticed at 20 week ultrasound and became more severe by 30 weeks

Born at term weighing 5 lb. 0 oz. with meconium and nuchal cord x1; APGAR 2/7; 5 days in NICU

We were told he had a small placenta and thin cord; this was not sent to the lab

Tania (2005) – Possible partial placental abruption during labor

We were told the placenta had “two sacs”; it was not sent to the lab

I don’t think there’s any way around my RE on this issue - I'm sure my Gyn wouldn't get involved and I’ve only met with a perinatologist once almost three years ago (she said use Lovenox but I don’t think she’d overrule my RE on when to start). The hell of it is, the doctor at The Other Clinic was going to have me on Lovenox from transfer! I don’t know if Lovenox/heparin two weeks earlier would make any difference, but I sure don’t want to end up holding another dead baby and wondering “what if”. *sigh* I’m feeling anxious, desperate, and disobedient, but there doesn’t seem to be any way to get my hot little hands on those syringes.