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January 6, 2014

Anti phospholipid antibodies and infertility

Infertility is the inability to conceive and have offspring. More specific, infertility is also defined as the failure to conceive after a year of regular intercourse without contraception. Evidence is emerging that inability to conceive or recurrent miscarriage in a healthy patient can provide an early clue of an adverse health condition.

anti phospholipid antibodies and infertility
Investigation to disclose the causes of reproductive failure can therefore assist with an earlier management strategies, so it can provide a long term benefit for women and restore their natural fertility. There are many causes of infertility, one of them is thrombophilia. How thrombophilia causes infertility remains unknown and poorly understood. After excluding other physical or anatomical causes such as fibroids, uterine scar tissue, congenital abnormalities, and polyps, assessment of medical history of the patient is an important next step.

Thrombophilias are disorders of blood coagulation that increase the likelihood of inappropriate clotting. It can be a concern during pregnancy because in pregnancy, blood tends to clot easily. Thrombophilia can be both congenital or acquired. The most common form of acquired thrombophilia is antiphospholipid syndrome (APS). In APS, there are antibodies against phospholipids in association with either vascular thrombosis or recurrent misscariage.

Laboratory test
For women with medical history of recurrent miscarriages, they are recommended to be screened for antiphospholipid antibodies. The most significant antibodies (immunoglobulin) involved in APS are lupus anticoagulant, anticardiolipin (ACA), and anti beta 2 glycoprotein 1 & 2.

Treatment
There are two options. First is oral antiplatelet (aspirin) and the second is UFH (unfractionated heparin). Combination of both therapies may reduce pregnancy loss in APS-positive cases by as much a 54% compared to aspirin alone.

Thrombophilia and contraception
Estrogen-containing medications can increase the risk of venous thromboembolism including deep vein thrombosis (DVT). So don't hesitate to contact your doctor to choose the best contraception for you.

How to avoid blood clot?
Control your weight, do not be overweight. Keep a healthy diet, avoid saturated fats. Keep your cholesterol level low. Stop smoking. Lower your blood pressure. Controll your glucose level (if you are diabetician). No more than 14 units of alcohol per week.
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