QuestionHi Dr, I'm 33, 2 children ages 16 and 9
I have a couple of questions, The first is I had a miscarriage started bleeding on 2/12/06 & stopped on 2/19/06, When can I start Provera to bring down my cycle? I also have read from some of your past post that you suggest taking the Provera twice a day for 10 days, is that 2 pills at the same time each day?
Also I was told when starting Clomid I should begin them on my 3rd cycle day, But I remember reading in a past post I believe you suggested taking them days 5,6,7,8 and 9, is that correct? And also why those days?
Last but not least I have had over 20+ miscarriages, this last pregnancy was the first one on Lovenox 60mg once a day, 81mg of asprin, folic acid, pre-natal pills and B vitiamins, it still ended in a miscarriage at 6-7 weeks like all the rest.
I was told in October 2005 I had Anticardiolipin Antibody Syndrome, When I went to see another Dr a couple days ago to take a HCG test to make sure the levels had dropped, she said that looking at my records my cardiolipin levels were never elevated?
After all the research I have done I believe I may have APS, I will be seeing a Hemotoligist on 3/15/06, is there any thing specific I should have have him to check for? I have to get to the bottom of what's going on, We want another child so bad, and something is causing me to miscarry every time I conceive, my youngest daughter was born at 26 1/2 weeks!
Dr, any advice will be so helpful, Thank You so much as always.
PS: When taking the Clomid what days should I ovulate on? Thanks again
AnswerUsually, after a miscarriage, you will get your next period in 4-6 weeks. If you had the miscarriage on February 12, you are due for your next period after March 11. I would wait until March 20. If you do not get your period, you can take Provera 10 mg twice a day for 4 days and you should get your period within 10 days. You can take the two pills together or one in the morning and one in the eveing. It makes no difference.
Clomid can be taken in many regimens. I use the 5,6,7,8, and 0, while other practitioners start on cycle day #3. It is arbitrary. Usually, you will ovlate on cycle day #14 after using clomiphene in any regimen.
If your anticardiolipin antibodies are not abnormal or if there is no evidence of antiphospholipid syndrome, you do not need to be on blood thinners. (I still would recommend aspirin, folic acid. amd antenatal vitamins). I would not recommend B vitamins. If you have miscarried so often, have you ever checked your progesterone level? If it is decreased, you may benefit from progesterone supplementation. Often, progesterone will help prevent miscarriage.Antiphopholipid is identified with Lupus anticoagulant, Beta glycoprotein I-dependent anticardiolipin antibodies, or both on two occasins at least 6 weeks apart.
