MTHFR question (losses mentioned)

[doodler]

Hello faithful friends.  Some of you know my loss history, or if not it is in my siggy.  Last week we met with the OB to discuss some RPL testing.  She is not recommending any additional testing due to the fact that 1.  I have a child and had a healthy pregnancy and 2.  The last loss was not something that is passed down from DH or I.  

Also, I have already had a clotting panel done when I was pregnant with my son because of some issues my Mother has.  I was told that the tests all came back normal.  When we met with the doctor I asked her about MTHFR.  She all but rolled her eyes but did take a look back at the testing and saw that I tested positive for one mutation(I think that is how you say it?)  She then quickly brushed it off and said that it's not a big deal.  

I've been researching and I read the recent thread from akraus2015.  I wish I had paid more attention before my appointment so that I would have been armed with these questions, but I wasn't expecting this.  It appears that some naturopathic doctors think that the MTHFR mutation is a big huge deal, and others think it is no biggie.  My OB is clearly in that camp.  My questions at this point are about the folic acid/folate issues.  Is that something I should be concerned about?  Do you think I should reach back out to the OB about it?  Obviously the OB I saw with my son wasn't concerned, and neither was the OB in my current practice that I met with before this last loss.  I'm confused, help!

[littlelion]

I'm sorry you find yourself in this situation. It sucks that the medical field disagrees on this issue. From my understanding, the type of mutation you have results in the severity of the possible issues. It sounds like you have the least risky kind, and the one that is most common. I'm not a dr or scientist, so I guess my only advice is to find an RE for a second opinion.

And fyi, I do have MTHFR. I think with the 2 mutations, I'd have to dig up my paperwork to confirm.  

  

[teraiin]

I could be wrong but I think @led might have some info about MTHFR.

[icaughtfire]

Paging DanaScullyX

[notagoddess]

+1 to seeing an RE for full RPL testing.

[DanaScullyX]

doodler, I'm no expert, but I truly feel my MTFHR diagnosis changed my life. I had three early losses, and a previous OB who said I was crazy to ask for any testing. I found a new doctor, and I addition to low progesterone, she did all the testing and found my mutation. I was prescribed folgard, because MTFHR makes the body not absorb folic acid well enough even if one takes prenatals or other vitamins. I got and stayed pregnant the very cycle I started the folgard and progesterone supplements. I know it made all the difference.

I have no experience with an RE, but I do believe an OB who's willing to order the rpl blood tests and use the results is worth their weight in gold.

If I was you, I'd insist on, at a minimum, a prescription for folgard. Good luck.

[akraus2015]

@doodler, your situation sounds exactly like mine. I switched to a RE after my diagnosis and have been so happy with the plan we laid out. I will PM you in a bit.

[doodler]

Thanks for chiming in guys. I don't think I can leave this one alone. I just need to decide what I want my next step to be. I'm going to talk to MH about it and we will decide. He had no clue what I was talking about when I asked about it in our appointment.

[emilie]

I am a huge skeptic about naturopathic doctors, etc. I know that I have a double MTHFR mutation from one of those spit-in-a-tube DNA testing services. When I talked to my OB about it she recommended I take folate instead of folic acid, since those with the mutation don't process folic acid into folate as well. There are a couple prenatals that have folate instead of folic acid (New Chapter, Vitamin Code Raw) and I also take 800 mcg of Solgar methylfolate on top of that. I figure it can't hurt.

[hoopoe]

doodler, if you were reading akraus2015's thread, you probably already saw my response. Some variants of MTHFR can cause a cascade reaction - difficulty in processing folic acid, which can cause high levels of homocysteine, which can cause blood to clot at a higher than normal rate, which can cause miscarriage.

A couple of things:

My doc, an RPL specialist, tests only for homocysteine levels, not MTHFR, as the issue is really homocysteine, not simply carrying one of the variants.

Clotting issues (which is what high levels of homocysteine can cause) are thought to cause issues mostly later in pregnancy. My doc doesn't do an extensive clotting disorder panel unless one of the pregnancies has made it beyond 10 weeks. She told me the blood vessels where clots would cause problems haven't fully formed until around 8 weeks. According to that, MTHFR would be unlikely to have played a role in your CP, and the triploidy.

You don't mention your age, which could also play a role.

I'll third (fourth?) the recommendation to see an RE over an OB. However, depending on your RE, you may find them to be very conservative when approaching RPL. In my case, the first RE ran a standard RPL panel (all normal), and I then had a fourth loss under his care. He still sent me on my way with instructions to 'keep trying.'

Have you heard of the book Coming to Term? I highly recommend it for RPLers.

[doodler]

hoopoe I will have to pull out the original testing and see if they checked the homocysteine levels. Not counting the chemical pregnancy, both of the other babies measured 6w5d. The losses were very different but that was the same with both. Neither grew to 8 weeks. Also, I am 34, turning 35 in April.

[akraus2015]

Feb 29, 2016 19:07:55 GMT -5 hoopoe said:

doodler , if you were reading akraus2015 's thread, you probably already saw my response. Some variants of MTHFR can cause a cascade reaction - difficulty in processing folic acid, which can cause high levels of homocysteine, which can cause blood to clot at a higher than normal rate, which can cause miscarriage.

A couple of things:

My doc, an RPL specialist, tests only for homocysteine levels, not MTHFR, as the issue is really homocysteine, not simply carrying one of the variants.

Clotting issues (which is what high levels of homocysteine can cause) are thought to cause issues mostly later in pregnancy. My doc doesn't do an extensive clotting disorder panel unless one of the pregnancies has made it beyond 10 weeks. She told me the blood vessels where clots would cause problems haven't fully formed until around 8 weeks. According to that, MTHFR would be unlikely to have played a role in your CP, and the triploidy.

You don't mention your age, which could also play a role.

I'll third (fourth?) the recommendation to see an RE over an OB. However, depending on your RE, you may find them to be very conservative when approaching RPL. In my case, the first RE ran a standard RPL panel (all normal), and I then had a fourth loss under his care. He still sent me on my way with instructions to 'keep trying.'

Have you heard of the book Coming to Term? I highly recommend it for RPLers.

@doodler, this is pretty much what I was going to send you in a PM.  After the RPL panel came back normal, my RE did a SHG, which also came back normal.  So now we're trying again with progesterone supplements starting the day after a + LH surge or the day of confirmed ovulation via BBT