The Clotting Connection: Hidden Causes of Implantation Failure and Miscarriage

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TRANSCRIPT

(EDIT - we recommend a thrombophilia panel after 1 miscarriage)

 Have you been told that everything looks normal, but you've had multiple miscarriages failed IVF, or you can't seem to get pregnant?   📍 It might be a hidden clotting issue like thrombophilia, that standard fertility tests often miss. In this episode will cover what the thrombophilia panel is, when it's needed, and how a functional approach  can uncover silent blocks to implantation and pregnancy success.

Let's go.

 I am Sarah Clark, founder of Fab Fertile. For over a decade, my team and I have helped hundreds of couples improve their chances of pregnancy success, whether naturally or through IVF. We specialize in supporting those with low AMH, high FSH, diminished ovarian reserve, premature ovarian efficiency, and recurrent pregnancy loss through functional lab testing and personalized fertility strategies.

Today we're digging into into the Thrombophilia panel and how this might be part of your toolkit if you've experienced pregnancy loss or implantation failure, this episode is for you, is if you've experienced miscarriage or implantation failure, and you wonder if a clotting issue like thrombophilia could be the missing link.

Your blood work is normal, but you suspect inflammation, nutrient deficiencies, or hormone imbalances are being overlooked. You're preparing for IVF or you're trying to conceive naturally and you want a proactive, functional approach to improve clotting risk and support implantation.

Thanks so much for listening. I'm so thankful that you're here. Make sure you hit subscribe or follow, and if you know someone else who is on the fertility journey, please share this podcast with them.

 Okay, so let's get into the episode. We're talking all about Thrombophilia and why this matters for fertility. And so really it's an increased tendency to form blood clots. It matters for conception and fertility and pregnancy because it impairs implantation. Placental function and fetal develop development, and it's often missed or dismissed in conventional care unless there's a history of major cotting events.

So when a thrombophilia panel is needed, if you've had two plus pregnancy losses, especially in the first trimester, especially in the first trimester, if you had one or more second or third trimester losses, if you've had IVF implantation failure despite good embryos. if you've had preeclampsia or IUGR, interuterine growth restriction, placental abruption. Stillbirth, you have a family history of clotting disorders, strokes, or early heart disease. There's immune diagnosis such as Lupus or Hashimoto's.

And in women that have recurrent pregnancy loss, there's inherited thrombophilia such as Factor V Leiden,. Prothrombin G20210A, Protein S/C deficiency are found in about 15 to 20% of those with repeat pregnancy loss. So the Antiphospholipid syndrome, APS and acquired autoimmune clotting disorders present in about 5 to 15% of women with multiple losses.

And for women with second trimester losses, placental insufficiency or unexplained field demise rates may be even higher. So in the general population inherited thrombophilia occur in about 5% of Caucasians factor V Leiden being the most common. Lower rates in Asian and African populations.

Not all thrombophilia will miscarry, but they may be more prone to issues like miscarriage, especially the second trimester preeclampsia, placental abruption and fetal growth restriction. And so in 2012 some research here found in Obstetrics & Gynecology found that 15 to 20% of women with

repeat pregnancy loss have an inherited thrombophilia. A 2020 study found in Human Reproduction Factor V Leiden and prothrombin gene mutations were significantly associated with second trimester losses and stillbirth. And the American College of Obstetricians and Gynecologists (ACOG) recommends a thrombophilia testing in cases of second trimester loss, placental abruption, or severe fetal growth restriction.

So what's included in the panel? We want to do the Factor V Leiden mutation, the Prothrombin G20210A  mutation. The protein C and protein S levels, the antithrombin III deficiency antiphospholipid antibodies. And then optional, you look at the MTHFR gene variants, which can impact your homocysteine and methylation.

And so how our Fab Fertile Method in a functional approach is really looking at thrombophilia and fertility differently. Typically in conventional medicine thrombophilia is only addressed if the woman has a history of late term pregnancy complications, stillbirth, placental abruption, or personal history of the deep vein thrombosis or pulmonary embolism.

From a functional standpoint, we're looking at subtle patterns of inflammation, of nutrient deficiency, which I've talked a lot about inflammation, just a podcast episode on that hormone imbalance are increasing the clotting risk even if you're told your labs are normal. And so we want to look at this from a individual approach and underlying imbalances before they manifest into full-blown disease.

So you want to identify and reduce systemic inflammation. As part of our Fab Fertile Method we do food sensitivity testing, stool testing, looking at the DNA of the stool and genetic testing. We want to address chronic low grade inflammation that's going to increase your clotting risk.

So functional labs to look at. So high sensitivity, C-reactive protein. The fibrinogen levels your homocysteine. So I've done podcast episode on homocysteine. Full deep dive into that. And we're looking at your gut health. If you've got bacterial imbalances, pathogens, those are going to trigger immune activation and systemic inflammation.

And so you're going to do on that anti-inflammatory, nutrient-dense diet, take out the top allergens. Dairy, gluten, soy, corn, peanuts, eggs alcohol and processed sugar. Take them out for 10 days, systematically reintroduce over the course of 30 days. And then we do food sensitivity testing, and so being able to really fine tune that diet.

Addressing those food sensitivities. We have people take out dairy and gluten for 60 to 90 days. You and your partner are doing the elimination diet together. It's not just you. So you do the elimination diet together. We'll determine how he's feeling and which foods he needs to take out for a longer period of time.

We don't want to be coaching our partner. He needs to run his own race. He's going to make his own changes. But he does need to make the changes, not about just him, having pizza and beer and you're making all these changes. And doing an Omega-3 that can really help to thin the blood naturally and really help with clotting.

We want to support the methylation of the detox pathways. So in impaired methylation we've done episodes on MTHFR and methylation. That can raise homocysteine. A known clotting risk. And if you do know that you have the MTHFR gene variant you can have low folate or B12, poor liver detox to impact estrogen metabolism.

And that's another clotting trigger. So we want to test the homocysteine. Look at the MTFHR. Look at your B12 and your folate levels. Making sure you're taking methylated B vitamins. Don't be taking folic acid. So methylfolate or P five P. You want to support your phase one and phase two of liver detox.

So cruciferous vegetables, broccoli seed and I've done a whole podcast episode on liver, so check that out. You want to balance your hormones, especially estrogen, high estrogen, or poor estrogen clearance can increase clotting risk. It's often missed on standard blood work. But we can look at the Dutch test again.

The Dutch test will look at your hormone pathways, see which pathways are going down. I caution just doing one Dutch test and thinking that you've done everything that can be part of the solution. Looking at your adrenals and then looking to see how that impacts your hormones. You want to support your estrogen detox.

If we do find it's not clearing properly. You can look at DIM. Or liver support, and you gotta work with a practitioner on this. You don't just be taking DIM. You can balance your estrogen progesterone with seed cycling. That's can be helpful. We will bring in seed cycling, it's not our first kick at this, where we're like, everyone has to do seed cycling.

No. Vitex can be helpful. It takes three months to to work. If we're taking it, be able to monitor this, take it daily and then working on your stress regulation and looking at the gut health. So if you've got dysbiosis or gut permeability, you got leaky gut that can all fuel inflammation, which is going to drive clotting.

Certain bacteria can even produce some immune activators and it could be linked to preeclampsia or miscarriage. So we need to be able to look at the health of your gut. The health of the gut microbiome is key. So we look at that stool test to look at the microbiome, the inflammation.

So your calprotectin, maybe you are inflamed. And looking at your gut markers, your secretory IgA so your immune system really, how, that's how, that's if you're getting a lot of cold flus or you're getting a lot of infections we need to boost things up. We want to remove the pathogens, reinoculate with probiotics.

Repair. So add nutrients. So L-glutamine or zinc colostrum. Again, we don't want to do this by yourself. You can take a whole bunch of these things and maybe it wasn't right for you 'cause we didn't get the testing done. So we've got to work with a qualified practitioner. Part of my team, I have a functional medicine OB GYN, he's our medical case reviewer.

We have functional nutrition practitioners. That are going to review your testing and blood work, develop a protocol and a plan. We have fertility mindset coaches, so really being able to put this all together with the testing, being able to reset your nervous system and getting your body in the be the best shape and the stress and adrenals.

The chronic stress is going to raise your cortisol. Which impacts your blood sugar, inflammation, and vascular tone. And so high cortisol is going to suppress progesterone, which is needed for healthy implantation in pregnancy. We've done podcast episodes on progesterones. Definitely check that out.

And I got a whole article on that too. Dutch test so we can see what's happening with your adrenals in black and white so you can see it. Okay, wait a minute. It's supposed to raise in the morning and lower at night. Maybe yours is burnt out.

Consider some adaptogens. So ashwagandha or Rhodiola, blood sugar imbalance, lifestyle practices or breath work or somatic therapy. So working on that stress and adrenal piece is key. If thrombophilia is suspected. So we're testing the homocysteine. If there's elevated levels, there's an increased clotting risk.

Doing the stool test, look at inflammation and immune stress. Looking at your Dutch test is going to identify if you're not detoxing estrogen properly and your cortisol levels, omega threes to look to see if there's more inflammation.

You're clotting risk looking at your MTHFR. And so that'll give us a status for your folate and B12 and B6. Looking at the whole body here. I just went through a whole clinical testing in a clinical manner, right?

And so we need to take action, be our own advocate, get this testing done and look under the hood and dig deeper. The emotional component of dealing with this of things not working. You've had pregnancy loss first, second, third, trimester. This is heartbreaking.

There could be so much trauma and the adrenals and the stress component. Our mindset coaches specialize this, and it's really important to give voice to how you're feeling and to recognize you're not alone. We can't walk in your exact steps here, but our team typically has experienced fertility issues and if someone hasn't gone through it, they don't understand it, and it's being able to give yourself some grace, some compassion, leaning in on your faith, leaning in on the universe like spirit, baby whatever feels right for you to give you that calm and peace. And then each day looking at making some of these targeted changes.

Looking at the testing, see what's being missed, right? Be your own advocate. And then you can make informed decisions on when to start trying naturally on when to go for an IVF or when to go for retrieval or a transfer because you've looked at all these markers, so it's really empowering yourself.

Have lots of success stories, people that have had all kinds of losses before come to see us and then gone on to have their children. And so while we're trying to figure this out in times of uncertainty, just grant ourself some grace. And so if you wanted to get our eyes on your specific situation, send a message to hello@fabfertile.ca, subject line FERTILE, and we'll give you some options to help. Take care.