PAI-1 4G/4G and RPL

Kg14

0 Posts
Reply PAI-1 4G/4G and RPL Posted on: Dec 7, 2011 at 3:58am
Hello,

I am looking for information on PAI-1 4G/4G. I gave birth to my son at 38 years old with no complications. I am now 40 and in the last year I have had 3 miscarriages with unknown cause between 6-8 weeks with no heartbeat ever detected. Only finding on complete RE work up was PAI-1 4G/4G and borderline LPD (serum progesterone 14-17 at 21 days). Progesterone found to be low in first two miscarriages (8-11) but fine in third 19 to start.

RE's protocol is clomid for ovulation and lovenox post positive HPT. I am not comfortable with lovenox injections. Is this the only treatment option available or even necessary? Are there any less invasive or natural options?

Best,

Kim

Dr. Braverman

2026 Posts
Re: PAI-1 4G/4G and RPL Posted on: Dec 7, 2011 at 5:10am
this polymorphism has been associated with insulin resistance so a full w/u for PCOS must be done and sometimes the treatment lies in that diagnosis. As you can see from my PCOS video(yes I know I need a shave) this treatment is multifactorial. this polymorphism can also lead to clotting issues as well and yes sometimes lovenox is necessary. I would be happy to help guide your workup. Feel free to call me and schedule a telephone or skype consultation. Low progesterone is almost always a result of but not the cause of early losses.
Braverman Medical Team
Braverman Reproductive Immunology P.C.

Kg14

0 Posts
Reply Re: PAI-1 4G/4G and RPL Posted on: Dec 8, 2011 at 4:18am
Thank you. I will call and make arrangements. One follow up question. Does a glucose tolerance test (3 HR) rule out PCOS? I did have this test and was told my results were excellent. What does a full w/u for PCOS mean?

Dr. Braverman

2026 Posts
Re: PAI-1 4G/4G and RPL Posted on: Dec 9, 2011 at 7:48pm
no a GTT does not rule out PCOS, there are too many variables in PCOS for one test to rule it out.
Braverman Medical Team
Braverman Reproductive Immunology P.C.