What Do These Genetic Test Reports Indicate?

Brief Answer:
CAuse of miscarriages

Detailed Answer:
GOod evening

Thank you for writing on health care magic

Well I have reviewed your reports.

1. The possibility of antiphospholipid syndrome looks a bit unlikely here as the Lupus Anticoagulant and B2 glycoprotein 1 are both negative. Anticardiolipin is very mildly positive( 15), but a cut off less than 40 is not considered too significant.

2. Your other tests for prothrombotic state are within normal limits as well.Except Protein C which is high. ( low Levels of protein C are problematic)

With Miscarriages it is always hard to figure out the exact cause. You had a 1st successful pregnancy which would have been unusual with Antiphospholipid syndrome.

1. What i would suggest is, to repeat the tests for antiphospholipid syndrome once after 3 months as well to see if the titres are rising. Also get an ANA test done( another autoimmune marker)

2. As for insulin resistance, definately exercise plays a big role as it increases the utilization of insulin. If metformin is not working, You can hold it. It does not have a definite role in it although most people use it.

Hope the information was useful

Do let me know for more queries

Would be happy to help out

Regards
Dr Naval

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Brief Answer:
Antiphospholipid Syndrome

Detailed Answer:
Good evening

Thank you for your reply

Pertaining to your queries:

1. Well, for antiphospholipid syndrome there has to be antibody positivity along with the miscarriage events or thrombosis episodes. 2 miscarriages, that also with one after 10 weeks make it highly suspicious. But for now the antibody are negative. Never the less, you should repeat it again after 3 months to see if the titres are on the rise or they are static. Negative antibodies with miscarriage events is less likely APS. I would also suggest you to do ANa and ENA profile which will check for other autoimmune antibodies( for other connective tissue disease). As for antiphosphaditylserine, it another antibody which can be positive in APS but still the role and significance is controversial

2. Aspirin is a safe drug to take, even during pregnancy. It will help in the placenta to get implanted properly with proper blood supply. Most gynecologists use it in normal pregnancy as well. The only medicine which we need to think is , about starting you on Low molecular weight heparin during pregnancy. It is the recommended for APS management in pregnancy especially with miscarriage history. Curcurim pills help to suppress inflammation like in rheumatoid arthritis, but APS is not so much of inflammatory disease. So the role of these pills in APS is not so much.

3. Crinone 8 % is as such safe for pregnancy and progesterone does not trigger the antibody production. IT will help the corpus lutetium of the uterus in secreting the horomones during the pregnancy. If you have insulin resistance, you can get these hormones tested. But I am doubtful any management will change from it as you are able to conceive normally but not able to retain.

4. As per your diet modification, you dont need to change anything as it does not trigger the antibody production. Just dont let your weight increase

I guess the plan should be to continue Aspirin for now and repeat your serological profile after 3 months to look for the antibodies. Do discuss with your gynaecologist about Heparin during pregnancy

Hope the information was useful

Do let me know for more queries

Regards
Dr Naval

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