So many of our readers are dealing with challenging fertility issues that are related to their MTHFR mutations. Today we have wonderful guest post from nutritionist Aimee McNew, who also has personal experience with pregnancy loss. She will share with you practical steps you can take to diagnose and overcome your challenges in getting and staying pregnant. This may include going beyond MTHFR.

Pregnancy loss is devastating no matter what the cause, but it’s especially difficult when it happens again and again. With so many factors that can contribute to miscarriage, it’s hard to nail the reason down to a single cause, although MTHFR can certainly be a contributing factor. So what do you need to know, as a patient, to help prevent future pregnancy loss?

mthfr recurrent pregnancy loss

As a nutritionist who specializes in fertility, I work with women who want to have kids. Sadly, I also work with a lot of women who haven’t been able to have children or who have suffered miscarriage. I wish I could say I didn’t know what it’s like firsthand, but I can’t, because I recently lost my seventh pregnancy. I’m compound heterozygous MTHFR, along with other genetic and autoimmune factors. While no two women may face the exact same set of genetic or health factors when they’re trying to assess what’s causing their miscarriages, there are a number of ways that patients can advocate for themselves. I know, because I had to do my own research and make special requests from my doctor. I wasted many months, and lost several pregnancies that may have stood a chance if I’d only known more before I’d gotten pregnant. Either way, I want to give you the best chance to discover why
you’re having miscarriages, and how you can move forward armed with the best odds for success.

MTHFR

If you’re a regular reader of this blog, you’re well aware of how MTHFR can affect the body, including being a contributor in recurrent miscarriage, infertility, and birth defects. But you’re also probably somewhat aware of how to address it: methylfolate, methylcobalamin, a whole foods diet, etc. Typically these are the first things to be changed when a patient discovers that MTHFR could be contributing to their pregnancy loss. When I learned I was compound heterozygous, I tossed all supplements that contain folic acid, figured out an appropriate supplement program for me, and started on baby aspirin at my doctor’s suggestion. That, my doctor thought, was more than enough to “fix” my MTHFR problem. And then I had another miscarriage.

More Than MTHFR

While MTHFR gets a lot of buzz, there are a lot of other genetic mutations that can wreak havoc on the body’s ability to successfully carry a pregnancy. This is still a relatively new field of research, so sometimes the volume of information isn’t readily available. I started by getting a 23andMe test done, and then plugged it into the Livewello app to get some feedback on my genetic mutations. Since I’m a nutritionist, I was able to delve even further into my research and then spoke with my doctor about my findings. Not only do I have MTHFR, but I also have more than a dozen other mutations that deal with methylation. I have several mutations that are related to excessive clotting within the body, too. I spoke with my doctor about my concerns and my research, and she agreed to run some additional tests that 23andMe didn’t cover. These included Anticardiolipin antibodies, Lupus Anticoagulant, and PAI-1 4g/5g. While I didn’t test positive for the Lupus Anticoagulant, I did for all the others.

If you’ve had one or more miscarriages, I recommend getting the same testing done
that I did, as well as a full thyroid panel (including free T3, free T4, and Reverse T3), homocysteine, glucose, prolactin, and the standard cycle day 3 bloodwork to assess reproductive hormone health (estradiol, LH, FSH, and AMH). Progesterone should be checked around 7 days after you have ovulated. On that same note, I highly recommend tracking your cycle with a fertility app or calendar (I use Fertility Friend) so that you can give your doctors as much knowledge as possible when they’re trying to help you. You can use ovulation predictor kits, but you don’t have to. The book Taking Charge of Your Fertility is the gold standard for learning how to chart, and I highly recommend it. I didn’t start paying attention to any of these things until after my second miscarriage when I started to deduce that there was a problem. Get ahead of the curve because, in fertility, knowledge is most definitely power.

What Should Your Doctor Know?

As I said before, I had to approach my doctor with my concerns after doing a substantial amount of research. Some doctors will be very proactive and will order these tests before you can request them, but the majority aren’t going to consider miscarriage a problem until you’ve had at least three clinically documented ones. Early losses often don’t “count” to the medical world, since they can’t be verified by ultrasound, and yet, a large majority of miscarriages happen before six weeks gestation.

Not all doctors are created equal when it comes to addressing fertility problems or
even MTHFR, so you’ll want to find a doctor who (1) understands the connection between MTHFR and pregnancy loss and (2) has a game plan that involves more than baby aspirin. Yes, baby aspirin alone can work for some, but in many cases more intervention is necessary. I read study after study that showed correlation between heparin injections and a 54% reduced risk of miscarriage in patients with a history of recurrent pregnancy loss. I pressed my doctor, an OB, to give me the heparin along with the aspirin, but she was reluctant to prescribe it due to my history of miscarriage (fearing that I would hemorrhage if I had another miscarriage). I was frustrated, thinking that I was sure to have another miscarriage if I didn’t get the heparin, but she persuaded me that my odds were good on baby aspirin and progesterone alone. Even so, I had another miscarriage.

It’s important to find a doctor who will be proactive, not reactive. I began seeing a new doctor who laid out an entire plan and gave me his personal success rates with patients who had similar genetic and autoimmune disorders like mine. I didn’t have to request anything, including heparin, progesterone, and prednisone (a steroid medication thought to help calm autoimmune reactions that can terminate pregnancies). While not every doctor is going to immediately lay out a plan, you should feel confident that your doctor will do everything that he or she possibly can to help prevent future losses. This largely boils down to philosophy and how up-to-date they are on current research.

Self-Care Tips For Surviving Miscarriage

Whether you’ve had one or many miscarriages, they’re traumatizing and heartbreaking. Even if you find a doctor who can help to prevent future losses, to the best of their ability, it’s still going to take time to heal from what you’ve already gone through. Finding a new treatment plan often isn’t enough to heal the wounds or grief.

After going through seven different miscarriages, all of them somewhat different from the last, I have nailed down a few key areas where I now know how to take better care of myself.

Nutrition

Right after I’ve gone through a miscarriage, diet is the furthest thing from my mind. I tend to indulge in things I don’t normally allow myself on a fertility diet (read: lots of sugar), and generally give up on caring how many vegetables I eat. But this can only go on so long before it starts contributing to depression and other negative factors. I always give myself grace after a loss for a few weeks, sometimes even a month, but after that I pick myself back up and the first thing to prioritize is nutrition. Miscarriage wreaks havoc on hormonal balance, and the fastest way to overcome depression and rebalance the reproductive system is to support it with the proper nutrients. This is best done by eating plenty of green vegetables, fruits rich in antioxidants (like berries and apples), nuts and seeds (for minerals), and salmon (for good quality fat). Your diet doesn’t have to be pristine to make a difference, either, so just start adding one or two good-for-you items each day. Drinking plenty of water is essential, too, as it’ll help your liver flush toxins from your body and break down hormones.

Mind/Body Health

Of course miscarriage traumatizes much more than the body, and I have found it essential to address all areas of my mental and emotional wellbeing after a pregnancy loss. For me, this has meant regularly seeing a counselor who understands infertility and writing in a journal. I’m a writer, so naturally, I express myself in words, but even non-writers can greatly benefit from putting their thoughts on paper (or the computer screen). Miscarriage can attack a woman from every direction, including self-worth, work life, personal relationships, and even spiritual relationships. It’s essential to realize that you’re not alone in what you’re feeling. One of the greatest things I could have done for my mental and emotional health after pregnancy loss was to reach out to others who had gone through it. This primarily happened via social media, and I’ve since developed strong friendships with women who really get the difficult walk that pregnancy loss and infertility really is.

Physical Wellness

It’s easy to want to forget exercise in the wake of a loss, and again, for a few weeks or a month after a miscarriage, I wouldn’t do much of anything. But choosing to prioritize physical health can help to stave off depression, rebalance hormones, and perhaps most importantly, release endorphins. Endorphins are chemicals in the body that connect with receptors in the brain to help reduce a person’s perception of pain. So exercise can actually lessen the impact and severity of post-miscarriage grief and can speed the time to healing. Exercise doesn’t have to be long or intense to be beneficial, and in fact, I’ve found the greatest post-miscarriage benefits from taking brief walks (15 minutes or less) and doing 15-20 minutes of yoga or Pilates. Whether you do something once a day, or a few short workouts throughout the day, you’ll be contributing to your physical, emotional, and mental wellbeing.

Summary

Nothing really can make miscarriage easier, but knowing how to advocate for yourself through the process can restore a sense of hope, as well as support the healthy process of grieving.

If you’ve suffered a miscarriage or many, consider asking your doctor to run the
tests I mentioned above, listed here for your convenience:

Anticardiolipin Antibodies
Lupus anticoagulant
PAI-1 4g/5g
Thyroid panel including free T3, free T4, and Reverse T3 – Homocysteine
Glucose
Prolactin
Cycle Day 3 Bloodwork: Estradiol, LH, FSH, AMH
7 Days Past Ovulation Bloodwork: Progesterone

Depending on your results, it may be appropriate to ask your doctor to prescribe heparin, baby aspirin, prednisone, progesterone, or one of many other supportive medications or supplements. You should find a doctor who you trust to be proactive for your health. Track your cycle with a fertility chart, and ultimately: don’t lose hope. Even when odds look grim because of genetics or autoimmune disease, there are still many out there who defy the odds. Living a lifestyle that supports your own set of genetic and health needs, and keeping a positive outlook, will give you the best chance possible to conceive and carry a healthy pregnancy.

Seeking Health - Optimal Prenatal - 240 Vegetarian Capsules

About Aimee McNew

Aimee McNew
Aimee McNew, MNT is a certified nutritionist who specialize in women’s health and fertility. She runs a private practice and maintains a blog devoted to nutrition for women. She lives in Indiana with her husband and Gracie, their adorable Boston Terrier. You can also find her on Facebook and Twitter.

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17 thoughts on “MTHFR and Pregnancy Loss: How To Get the Answers You Need

  1. monika

    I am here searching for answers since I am having so much miscarriages I am still unsure as to what is happening. A bit of history about myself, I have over 9 misacrriages over my life span, some at 3, 4, and even 18 weeks with twins. All through IVF both fresh and frozen cycles, my last M/C was the ending of May this year which ended at 14 weeks. I tends to suffer from subchronic heamatoma where bloodtclot is form between the uterus and the fetus. I was put on predisolone, cleaxene , asprin and progestrone but nothing could stop the M/C. I was tested for all sort of things but the few that was found was only borderline. I told my OB about mutation but was told it’s not important and it doesn’t proven to be a contributing factor to the M/C. Now I am having my last go with a frozen tranfer and I am determine to advocate for myself in this area. I sent off for a kit in America to have a mutation test done through 23andme and am hoping to get even a closure to this problem that has been such burden to me for the pass number of years. I am still waiting for the result which will take a few weeks. If am honest, I am convience I have some form of mutation added to the rest I am struggling with, but doctors are not happy when you told them you have been doing research on the internet, they feel like you are underminding their work but no one knows what it feels like to have so many M/C hence I will do anything just to bring my little one here becuase I don’t have any kids and I am mid 40 now.

    Reply

  2. lara

    Hi Andrea,

    Your blog has been such a light to this very difficult diagnosis. I recently was tested and found to be homozygous for both C677t and A1298c. It has been my hope always to have a large family and I feel so lost with this discovery. Everything that I have found online has indicated that it will be almost impossible for me to conceive. I was hoping to get your opinion on this?

    Reply

    1. Andrea

      Hi Lara, did you mean to say homozygous (2 copies) for both 677 and 1298?? Or are you actually compound heterozygous with ONE copy of each? Assuming the latter, this is what I have and I am enjoying a healthy, happy four month old right now…so please don’t feel like it is impossible. I had to do a lot of work on my health to get pregnant but I did conceive without any drugs or IVF. I recommend reading through the posts on this blog in order and seeing whether any of my health discoveries are relevant to you. Good luck!

      Reply

  3. Valerie

    Thanks for sharing this information! I had ‘unexplained’ (unexplored?) infertility for 4.5 years (repeat implantation failure). After 3 doctors in 3 states, my 3rd doctor tested me for the full autoimmune/thrombophilia panel and I tested positive for Antithrombin and one copy of MTHFR C677T. My spouse tested positive for 2 copies of MTHFR. I had been on baby aspirin for previous IVF cycles. The next cycle we did, I started Lovenox on cycle day 12 and we conceived! Finally! Fortunately, I had been on all of the methylated forms of the B vitamins 3 months prior, throughout my pregnancy, and while nursing. (I stayed on Lovenox the entire pregnancy, too). I’m grateful to have learned about MTHFR prior to pregnancy and prior to vaccination. Many reproductive endocrinologists aren’t familiar with MTHFR or are skeptical, at best, of its implication in infertility. They will check your homocysteine levels (which will often be normal) and state that no treatment is necessary. Worse than that, they tell their patients to take the regular prenatal vitamins with synthetic folic acid.

    Reply

    1. Erin

      Valerie, thanks for your post and I’m hoping you still check this to be able to answer. My husband and I, too, have been diagnosed with unexplained infertility and are beginning to explore the decision to do IVF in the future months. My naturopath recently discovered that I am homozygous MTHFR C677T and has recently placed me on a supplement with active forms of B6, B12 & Folate. Did you guys finally conceive via IVF on the cycle you were using Lovenox?

      Reply

      1. Valerie

        Yes! We did! We have a healthy 20-month old daughter. It was our one and only positive pregnancy test. My RE and my high-risk OB stated I could wean off of the Lovenox between 9-13 weeks, but after all my research, I wanted to stay on it through the whole pregnancy. I told them that was my desire and they agreed to it. I did wean off the week before I delivered. I also started the Lovenox on CD12 of my IVF cycle v. the suggested day of embryo transfer. I was on 40mg/day, if I recall correctly. FYI: my subsequent research also uncovered a couple of studies concerning higher risk of adverse events from vaccines in people with MTHFR, of which my daughter has at least one copy.

        Reply

  4. Pingback: Date night, Whole 30 Dinner Fail and MTHFR | My Healthy Happy Home

  5. Sacha

    Hello; After 2 m/c’s I discovered I have MTHFR, how long should i treat for MTHFR before trying to conceive again? If I start taking all of the correct vitamins and supplements one week prior to ovulation, is that enough?

    Reply

  6. Heamardon

    Hi there, I’m desperate trying to get some guidance. A few years ago, I was told I’m B12 deficient and tried B12 shots and Deplin, but both made me feel like the Incredible Hulk, irritable and anxious. So I stopped.

    But now I’ve had 2 early miscarriages and I’m concerned it’s related to my B12 deficiency. My reproductive endocrinologist refuses to test me for MTHFR because she feels it’s “pointless.” I would like to try supplementing myself to prevent another miscarriage, but I have no idea the differences between the methylcobalamin and methylfolate and all of the other forms. Do you have any suggestions?

    Reply

    1. Andrea

      I’m sorry for your losses. Methylcobalamin is a form of B12 and methylfolate is B9, a replacement for folic acid (the latter is synthetic). You would want to take those together. Hope this helps!

      Reply

  7. rebecca

    I have a 5 year old daughter did have preeclampsia during my end of pregnancy. I just suffered my first miscarriage on Dec 24 2014. And was diagnosed with genetic. Mutation. I would like to try again but want to take the right steps this blog is very informative I know what to look for in a dr

    Reply

  8. Anne

    These last two guest posts are excellent. Thank you for including them, for keeping your blog current even though your mind is elsewhere at the moment. In fact, the first guest post got me focused on finishing up what I’d started a couple months ago. With these posts, you made it easy, and I thank you. There is so much information, so much to sort through to get to the quality info that it can be overwhelming, but you made it much easier.

    Andrea, wishing you the very best – I know you’re getting close, and I am so happy for you and your burgeoning family!

    Reply

    1. Andrea

      I’m so happy to hear you find this blog so helpful, Anne – it is wonderful feedback. Thank you so much for your well-wishes! Will plan to write more in the new year after the baby arrives and we all settle in. Happy Holidays =)

      Reply

  9. Megan

    Thanks so much for sharing this information. I definitely am printing it all out and talking with my dr. I continue to pray for you and ask The Lord to bring about sweet joy even in the midst of great pain.

    Reply

  10. Amber

    Thank you so much for this detailed information! You will never know how much it means to us that are still learning (: best wishes on your journey as well!

    Reply

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