Factor V Leiden & Pregnancy: A Patient's Story & Medical Insights

Question
Dear Dr Rappaport,
I am 37 and have a 10 month old due to IVF. He has been a true miracle for us. Low and behold, we are pregnant again! My last cycle started November 23. This preganacy is another true miracle! Our 10 month old started out as a twin. The twins pregnancy failed to thrive and we lost the baby in the 11th week. It just absorbed luckily. I had to do 40mg lovenox shots during the pregancy due to Leiden Factor 5(found in my family). I was told during the last pregnancy that without the lovenox shots, I had a risk to miscarry.The lovenox shots this pregancy will run us about $3500. I hate to say that it boils down to money because you can't put a price on the life of our baby. I guess we just wonder how big of a risk it is to go without? I can't remember whether I have one gene or two of the Factor 5. Let's just assume 2. I do take a baby asprin everyday to help my blood. I did this along with the shots before. I am also on a natural progesterone cream to help balance my hormones(arbonne). I have just continued to use this since I'm pregnant. We are thinking that this baby is such a blessing and a miracle that if it's meant to be, why take the lovenox shots? Then again, if anything were to happen, we would feel horrible. My sisters have had 7 pregnancies without this being an issue. I think it may have been before this gene was discovered. They were all a lot more young and thinner than me when they had their babies. I'm not sure it matters at all, but our 10 month old ended up being a c-section. He did not respond well to being induced. I'm guessing this pregnancy will be a c-section as well. I hope I've given you enough info to go on. This is a real dilemma for us. We just would like to be as informed as possible and there is not a lot of information on the lovenox pertaining to pregancy. Thank the lord I stumbled onto this site! If you can help, you may be our 3rd miracle:) Thank you, Amy

Answer
The bottom line is that if you have Factor C Leiden, there is a higher risk of miscarriage if you do not take anticoagulant therapy during the pregnancy (Heparin or Lovenox). I know it is expensive, but there is no other choice. You certainly could "take a chance" on not taking the Lovenox, but you would feel terrible if you didn't do everything you could to protect the pregnancy. There is no reason to suspect that you probably will need a cesarean section again. Every pregnancy is different and you may not require a repeat cesarean section.