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Does Your Doctor Suspect You Have APAS? Here Are The Treatments He May Prescribe
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  • I see hundreds and hundreds of requests from women to join the Antiphospholipid Antibody Syndrome (APAS) Facebook support group. APAS is just one of the five reproductive-immune disorders (RIDs). While we are happy to have a safe space for these women online, it’s also saddening that there are so many couples out there suffering because they still could not hold a baby in their arms.

    Typically, a woman or a couple is suspected of having a RID after experiencing recurring miscarriages. The first thing to do after knowing you might have a RID is to search for the right doctors who have experience with the condition and have had successful deliveries.

    Your doctors will then prescribe different immunology tests to determine the various categories of RID that you may have. Yes, you can test positive for more than one category. The results of your tests will help your doctors diagnose you and find the best course of treatment to help you get pregnant.

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    Treatment APAS and other reproductive-immune disorders

    The truth is there are no set treatments for RIDs. Each patient is treated based on her medical condition, and each immunologist has his way of implementing the treatments found below. Note that this list is only a reference for the various treatments given to APAS and other RID patients and is not meant to substitute medical advice from your doctors.

    Lymphocyte Immunotherapy (LIT)

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    Lymphocyte Immunotherapy involves having white blood cells of the father (or a donor) injected into the skin of the prospective mother to prepare her immune system. Based on the procedure that we had, doctors extracted around 18 vials of blood from my husband. His blood’s white blood cells were isolated in the lab and then injected on my inner arm.

    Administration of blood thinners

    Blood thinners such as low-dose aspirin and heparin injections are prescribed to the mother to address blood coagulation issues. Your doctors will handle dose and dosage that varies from patient to patient.

    Steroids

    Corticosteroids are typically used to treat life-threatening autoimmune diseases such as lupus, severe allergies, and to prevent rejection of organ transplants.

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    Fat Emulsion Therapy

    An example of fat emulsion therapy is intralipic. According to the U.S. National Library of Medicine (NCBI), it is a synthetic product composed of 10% to 2% egg yolk phospholipids, 2.25% glycerin, and water. In vitro investigations revealed the ability of intralipids to suppress natural killer (NK) cytotoxicity. In both animals and humans who have abnormal NK cells levels or function, studies show that intralipid given intravenously may enhance the implantation of a fertilized egg.

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    With my first successful pregnancy with my son Santiago, I had seven intralipid sessions. With my pregnancy with my daughter Lucia, I only had two. Your doctors will evaluate you regularly and determine how many sessions you need.

    Thyroid medication

    Medication is given to those with thyroid issues. In my case, I was also diagnosed with subclinical hypothyroidism, a mild form of hypothyroidism, a condition in which the body doesn't produce enough thyroid hormones. I was taking thyroid medications during my whole pregnancy.

    Intravenous Immunoglobulin (IVIG)

    According to NCBI, intravenous immunoglobulin (IVIG) is a blood product prepared from the serum of between 1,000 and 15,000 donors per batch. It is a treatment option for patients with antibody deficiencies.

    Cost of APAS treatments and other RID treatments

    It is true that treatments for RID pregnancies, especially if you “qualify” for several categories, can be expensive. Some patients spend millions before they can hold their dream babies.

    I would have never thought that we could sustain the treatments when our doctors discussed with us their protocols. My husband and I were two regular corporate people making a decent living. We may have had disposable income, but we did not think that we could afford all the treatments we required.

    At first glance, the amounts we need to spend are really nakakahilo and nakakapanghina. But before you lose hope, let me share with you what I have learned from our experience.

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    First, the treatments come in tranches. It is not a one-time payment thing, so you have time to earn what you have to spend on the pregnancy.

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    Second, there will be doctors who are definitely more expensive than others, and that includes the medical protocols they require. Do your research on the doctors. An excellent place to start is the APAS and RID Facebook Support Group

    Many success stories have inspired many couples in the support group. Provision arrived through help from parents and family, an unexpected bonus or sale of something, an approved personal loan (because yes, having that baby is an investment, not an expense). But, of course, it is always best to be prepared for it so that you don’t go through the unnecessary worrying when you are already pregnant.

    Balot Del Rosario, a member of the Smart Parenting Mom Network 2020, is a NAHA-registered, Certified Level 2 professional aromatherapist. She is also the author of the book, Lost but Found, and the mom-of-two behind the blog Chronicles of The Happy APAS Mama (www.callmebalot.com.)

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