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Discussion Starter · #1 ·
Can you any of you ladies give me some advice or let me know what you were prescribed for immunes with regard to clexane.

I am doing my immune therapy through Dr Gorgy.  I have very mild immune issues  (CD19  a little out of kilter and a little higher than average killer  cells. I am also homozygote for MTHFR).  Dr Gorgy has prescribed me with prednisolone, intrallipids and  clexane.  The question I have is about the clexane.  He is prescribing  me with 40mg to take every evening from day 5 of stims upto the day  before egg collection and then none on day of egg collection and then to  start again with 40mg every evening the day after egg collection, and  then to also add 20mg every morning until pregnant.  So after egg  collection this 60mg!  This seems like a lot. Can anyone let me know  what they were prescribed re: clexane for immunes.

I am not doing the IVF through Dr Gorgy, but at a clinic in my hometown. They will not deal with the immune issues, but are willing to prescribe clexane, but only 20mg from the day after egg collection. I'm a bit worried that clexane would thin the blood so much that it would stop the embryos sticking.  I was advised by Prof Regan at St Mary's not to take low dose aspirin from embry transfer as this would stop embryos sticking.

I feel I seem to be getting differing advice.  Any advice or info on what any of you ladies have been prescribed for clexane would be helpful.


Thanks
:)

Thanks
 

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well, he normally pxs 40mg for mthfr hetero and/or elevated nka but the theory is that mthfr **** is more severe hence the slightly higher dose.  if you had factor v leiden as well, i think he px's 80mg.  the ladies on the pg with immunes thread have been on 40-80mg.
 

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Hi

I've been on 60mg of clexane since just after egg collection too.  I am also **** for MTHFR and have elevated NKs.  All I can say is that it worked for me - prior to this successful cycle, I had only been on aspirin and that hadn't been strong enough to work for me. 

Since getting my BFP however, I've had big rows with my OB, haematologist and GP about being on 60mg.  They have all wanted me on 40mg.  I raised it with Dr G and he talked to me about a study which said 60mg was still a relatively harmless dose in the scheme of things.  In the end, I have now agreed with Dr G that I will stay on 60mg until 22 weeks and then move down to 40mg to keep my other doctors happy.  I have no regrets about being on 60mg - it worked for me and got me that elusive BFP.  I've had a very positive experience of working with Dr G and trust his judgement implicitly on these things. 

I am really surprised about what Prof Regan said to you - my understanding from other people who've dealt with her is that she strongly recommends aspirin to aid implantation.  If anything, she is slower to prescribe clexane than other doctors though......

Remember that with **** MTHFR, your blood is already "sticky", so taking the clexane and / or aspirin thins your blood and enables your embryo to stick - without clexane, your embryo won't be able to implant.  The way I used to imagine it is that an embryo implanting creates a small "cut" in your womb lining.  If your blood is too sticky, then that "cut" heals too quickly and so the embryo can't implant in the "cut".  However, if you're taking clexane, then the "cut" can't heal so quickly and your embryo has the chance to implant. 

Hope this helps.

J
 

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Discussion Starter · #4 ·
Thanks ladies for your answers. I feel much more reassured now.

Congratulations J on your BFP - thats just great news. 

Unfortunately I'm quite a bit older than you (43 now), so if it doesn't work for me, it will probably be down to my old eggs. :( .  I've been diagnosed with MTHFR since 2008 now and nobody has prescribed me with clexane  - it was not until I was diagnosed with immune issues as well that the clexane was offered on the menu.  I do feel that is a big deal for me as I was 40 3 years ago and that makes a big difference in fertility terms. Quite angry about it, but I suppose there is not much I can do about it now.

Anyway, thank you very much for your replies.

Mouse
 

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im on same clexane dose 40mg in morning and 20 in evening- i have heter mthfr and factor v leiden-. my haemo put me on 40mg but he did think that he might increae as weight increased with pregnancy- i have not spoke him since- currently trying and failing to get dr g to write to my gp and haemo, Unless you have bleeding problems develop i cant see its a massive dose.

with regard to asprin- dr G told me there was a deabte going on about asprin effecting implantation which contraindicts research that says it helps so  he had me  stop aspring at ec and restart on bfp to cover all basis on basis i was taking clexan any way- I have to say without looking into the science knowing that asprin coats platlets making them less likely to stick makes sense the thinking about implanttation but then again alot of asprin babies out there!
 

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hi  girls

Im hetro - ive been told 20mg before ec then 40mg after is this enough????

also I asked DR G briefly about asprin he say yes ok to take but dident say when to stop/start

hope you all get your BFPS xx
 

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nat: that's the normal dose for mthfr hetero that dr g px's.
 
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