Testing positive for antiphospholipid antibodies and elevated natural killer cells

Chels, sorry to hear about your MC's. Hopefully you can get some answers now. Did your Doc say anything about re-testing? I tested positive for APA in May and was sent to re-test 4-6 weeks later ( I had a few chemicals so the Doc wanted to test me just in case). They do that to make sure those high levels are not just a "fluke". In my case, the re-test showed normal levels, so I am in the clear. When my Doc talked to me about it the first time, he said it can be treated with baby Aspirin and/or Heparin. From what I know, it doesn't necessarily mean that you're more likely to have lupus, although people with lupus do have high APA (weird, I know). If you do have confirmed high APA, then it's definitely something that could've caused the M/Cs. I think you would only need drugs for your pregnancy. I understand that it's treatable and hopefully this is just what you need to have a happy and healthy pregnancy! Good luck at the Dr's next week!!!

thx silver - yeah, maybe they will retest. I didnt get to talk to doc just the nurse over email and she didnt seem worried about the test results, she also didnt say anything about stopping the donor cycle so im not sure whats going on.

Chels-

I have APAS as well as Lupus & the two do kind of go hand in hand. I am sure you were tested for other clotting disorders at the same time (factor V, Protein S deficiency, Lupus anticoagulant, etc) & if those were negative then the chances of you developing a clot from APAS alone is extremely unlikely. By definition if you have had more than 2 m/c's AND have a clotting abnormality you fall into the category of APAS regardless of the rest of the tests. You tested + for antiphopholipid antibodies, APAS is the syndrome that describes multiple m/c's + a clotting disorder. I was tested by my RE & found to be + for Factor V, Protein S & was classified as APAS. Since I have multiple clotting factors I am on Lovenox (a form of heparin) twice a day. I am now 16 wks, so it is working well so far. It will be up to your OB when you get pregnant if they think Baby aspirin is enough or if you need Heparin/Lovenox. It sort of depends on the doc, but you definitely should be checked (if you haven't already) for other clotting disorders because that will definitely change things. As far as your ? re donor egg, if the recurrent m/c's was the only reason taht you were going this route then you definitely do not need to. Regardless of who's egg it is, your body will treat the pregnancy the same. I am not too familiar with the natural killer cells, although my understanding was that this mainly had to do with your body attacking sperm cells, so I don't think this would affect IVF. With you entire work up they most likely checked an ANA which is the best test we have for Lupus. A diagnosis is made by doing this blood test & combining the results with a list of symptoms & depending how many checks you get on the list they decide if you have it or not. Basically if you have a + ANA then you have some sort of autoimmune disorder, for fertility purposes this is sufficient, so if this is negative then you should be just fine. Please let me know if you want me to list all of the disorders that you should be tested for so that you can check with your doctor to make sure they have been done. Take care & good luck with your appt next week.

That's great info Meghan - thank u so much!! I actually tested negative for the ANA so that is good. I wd like u to send me info on any other disorders. I just want to know as much as possible b4 I talk to doc so can talk to him about any n all things. The miscarriages were the only reason for the donor cycle really, after my 2nd ivf they said the eggs weren't all tjat great however they all fertalized and two implanted, then I m/c'd again. I will need to talk to him about that as well. This is just crazy cuz I had finally come to terms with a donor cycle and now I may not even need it. You wd think I'd be excited but actually I'm scared again. The donor cycle was there to keep me from the pain of another m/c but knowing this I wd hv m/c'd again anyway (most likely). All these emotions r running thru me now, how weird! LOL

Great info!

Yes, retesting Moderate values of APA is always warranted... Treatment with Heparin/baby Aspirin is usually only considered during early pregnancy and/or ovulation induction

Chels-

The clotting panel you need to ask for is the Hypercoag panel. Make sure it includes the following

Factor V Leiden Mutation

Protein S & C activity

Lupus Anticoagulant

MTHFR

These are the main ones & you may have already been tested for them. I know the feeling when all you have wanted is to know what is wrong & then when you do it is scary to face. I knew that I had Lupus going into TTC, I was diagnosed a while back. I didn't know about all of the clotting stuff & the scary thing is that I had been on birth control pills for years! I was terrified of giving myself injections (go figure being a nurse!) but I got used to it. When I initially go pregnant I met with the perinatologist & she informed me that I wasn't on enough Lovenox & that I needed to do it twice a day! It was overwhelming at first but now it is just like brushing my teeth. As my belly is getting bigger it feels weird doing it in my stomach, even though I know I can't hit the baby or anything, it just seems strange. Looking back now, I am so glad that we knew what was wrong & didn't fall into the category of unexplained infertility or m/c. Also, there is way to treat this type of thing, so that is also a big plus. It's no fun being considered a high risk pregnancy, but I'd much rather have that then not be pregnant at all. Having APAS alone should not impact you outside of pregnancy, so that is good. I know this is scary but you will get through it & hopefully you will have a successful pregnancy really soon!

great, thx. i will take the info with me to the doc 2moro to discuss the test results.

thanks again!!

talked to doc and he was more than happy to test for these as well. I guess they didnt test for some cuz we were gonna do the donor egg cycle and wouldnt have needed to know about those for it.

Again, thx for all the info, you have been more than helpful!!

ok, here is what i got from the nurse about more testing...

Dr. would like to see you have the following blood testing:

Thyroid antibodies

TORCH panel

hemoglobin A1C

Sed Rate

CA-125

Thrombophilia Workup: Factor V Leiden, Prothrombin Gene Mutation, Protein C Activity, Protein S Activity, Antithrombin III, Antithrombin I-1, and lipoprotein A

This would complete the Habitual Abortion Workup.

oh and

Lupus anticoagulant and MTHR