Antithrombin III deficiency and pregnancy

This post is a bit of an educational one and is perhaps more relevant to the infertility warriors out there than the pregnant mammas.  But keep reading pregnant mammas as maybe you’ll learn something hear that one of your friends might find interesting.

As part of my investigations into possible causes of my multiple miscarriages, I was tested for something called Antithrombin III deficiency.  The results showed that I did in fact have a mild deficiency which, put very simply, means I am more prone to thrombosis or blood clots than the average person.

It is good to be aware of if for no other reason that if ever I am having a major surgery I can let my medical practitioners know to take extra precautions to prevent blood clots forming.

What makes it a particularly big deal for me is that it may have been a contributing factor in my infertility and multiple miscarriages.  It is also a big concern when you are pregnant as a blood clot is generally considered a bad thing for both mother and baby.

I am really happy that I went and saw a haematologist separately to my IVF doctor as haematologists are more specialised in this and I found my IVF doctor was and still is sceptical as to the relevance of antithrombin III deficiency.

The treatment that I have been given to offset the risk of thrombosis has been a daily, self-administered injection of a blood thinning product, in my case it is Clexane.  Many IVF doctors do give a low dose of Clexane as part of the embryo transfer process (you usually start a daily dose a couple of days after your transfer), but in my case I needed a higher dose in order to combat my deficiency.

So yes, I have been jabbing myself every single day with a blood thinner since mid-November last year and I will continue up until the birth and then for six weeks afterwards!  Let’s just say that with the IVF injections and now the Clexane, I am not at all squeamish about giving myself injections anymore.  In fact, I am incredibly efficient about it – it probably takes me less than 2 minutes and that includes unwrapping the injection from it’s packaging.  I am a pro at injections these days!

At about six weeks pregnant my haematologist checked my antithrombin III levels again and found that the dosage of Clexane was sufficient at the time, but she did caution me to come back to be tested again once I’d gained some weight with the pregnancy.  Weight gain and increased blood volume can impact the effectiveness of the dosage.  So back I went to be tested a week ago and I was freaked out to learn on Friday that I need to almost double my dosage of Clexane as I am back into the risky zone for thrombosis.  Eeeeek!

Actually I expected to have my dosage increased as I had noticed I stopped bruising so very easily which I did at the start of my pregnancy.  It was a sign that my blood was not so thin anymore.  I don’t know why, but I felt kind of sad for 24 hours after hearing I had to up my dose.  I think I’d gotten to the point where I felt like all my struggles to conceive and failure to be a “real woman” had started to melt away and this was just a reminder that this pregnancy is a miracle of science as much as anything.

But really it’s fine.  It’s important I do everything in my power to keep baby and me healthy.  So what if my dosage is increased? So what if I have a couple of bruises here and there? This will all be forgotten in the sands of time.

Moral of this story though is that if you too have had multiple miscarriages, especially missed miscarriages like I did, then I suggest you go and also have your antithrombin III levels tested.  It’s a very specialised test and so regular blood clinics might not do it.  It’s also expensive, but it’s probably some of the best money I’ve spent during this whole process.



17 thoughts on “Antithrombin III deficiency and pregnancy

  1. Such an informative post and agree how important it is to know the facts.. in searching for answers as to the reason for my multiple miscarriages, we suffered five before conceiving our son. I too found out I had protein S deficiency and was on clexan until 34 weeks… it’s hard but like you say you get through it and so what you’ve got to do… when you hold bubba in your arms you’ll feel like a warrior!! Thank you so much for sharing your story.. ps you may end up with the clexane after c section too 😩but you’re a pro now… 🙌🙌🙌xx

    Liked by 1 person

    1. Only 34 weeks? Why did they stop you at that point? I am for sure ending up with Clexane for 6 weeks after c section. Lucky me!! It will almost be a year of Clexane by then. Ugh!!
      I have been on the 4000 dose until now. They’ve put me up to 7000 now. It feels like a lot!! 🙈

      Liked by 1 person

      1. It’s never ending hey!! My daughter was born at 34 weeks so as I stood a high chance of another prem baby they didn’t want me going into labour still taking a blood thinner. Thankfully as son born at 35 weeks 😬was on 4000 too, I didn’t miss the bruises lol!! How long have you got? Xx

        Liked by 1 person

      2. Aaaah ok. That makes sense. I’m surprised they didn’t try and control it all through c-section. I’m expecting to deliver around 38 weeks unless baby has other ideas. I think he’s pretty happy in there though. xx

        Liked by 1 person

      3. As long as he’s happy in there that’s the most important thing… up until I was told my son was going to be born within a day ( I didn’t go into labour they made the decision to get him out as I had no fluid left) I’d planned for a vbac delivery but little monkey was breech and no fluid meant he had to be born by c sec.. the good thing is at least you know the ‘plan’ in advance so you can prepare… 😀

        Liked by 1 person

  2. I have low levels plus Leiden Factor V and had blood thinning injections from transfer right through to 6 weeks postpartum. And boy did I nleed during the c section. Even though I’d had no jabs for 48 hours.

    Liked by 1 person

      1. Yeah. I had to have a transfusion and I was anemic afterwards and had to take high level iron tablets twice a day for 12 weeks until my levels were back to normal.

        Liked by 1 person

  3. Interesting. I’m glad you got it figured out, or at least as much as needed to be successful! Kudos for giving yourself injections. I never gave myself any of the IVF meds. S did it all for me! I don’t mind shots or needles, but I don’t want to stick myself with any!

    Liked by 1 person

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