To understand clotting disorders and how they might cause fertility problems, it is helpful to understand how blood clots. Proteins in your body form a clot when a blood vessel is cut. Sometimes blood vessels clot too much when these protein levels are too high. This can cause blockages that may lead to stroke, heart attack, pulmonary embolism, infertility issues, and, in rare cases, death.
When a blood clot develops, it is called thrombosis. When a person has a tendency to form excessive blood clots over a length of time, he or she may have a clotting disorder called thrombophilia. Unfortunately, you may have thrombophilia and not know it, as you may not have any symptoms until a serious problem occurs.
Pregnancy can be a sensitive time for women with clotting disorders. Estrogen levels rise during pregnancy, increasing your risk for blood clots for up to six weeks after childbirth. Thrombophilia during pregnancy can result in serious consequences for you and the fetus, including:
- Placental abruption (a pregnancy complication in which the placenta partially or fully peels away from the uterus)
- Pregnancy loss late in pregnancy, during the 2nd or 3rd trimester
- Recurrent miscarriage
Factor V Leiden is a clotting disorder that can cause blood clots to form in the blood vessels in the placenta during pregnancy. When this happens, pregnancy loss can occur. Antiphospholipid syndrome (APS) is another clotting disorder that affects up to 5 percent of women during pregnancy. In this autoimmune disorder, a woman’s body starts to produce antibodies that can cause blood clots. Most women avoid complications with APS, but some women do have problems, including deep vein clots, recurrent miscarriage, preterm labor, preeclampsia, restricted fetal growth, and other issues.
Testing for clotting disorders
If you have a known family history of thrombophilia, or are experiencing recurrent miscarriages, ask your doctor about testing and treatment for clotting disorders during pregnancy. Your doctor may also want to test for thrombophilia if you have had past problems with preeclampsia, stillbirth, or other pregnancy complications.
If you haven’t seen a fertility specialist, now might be the time.
If you have a clotting disorder, your doctor may choose to treat your condition to help improve your fertility and pregnancy outcomes. He or she may prescribe one of the following medications for short or long-term use:
- Baby aspirin
- Blood thinners
Your doctor may prescribe heparin if you become pregnant, which is safe for you and your baby, although some women do not need medication treatment for clotting disorders during pregnancy. After pregnancy, your doctor may prescribe a drug called warfarin. Warfarin is safe for breastfeeding mothers, but has been linked to birth defects when taken by pregnant women. If you take one of these medications, your doctor will monitor you to make sure that you do not bleed too much or develop harmful clots. Talk to your doctor to learn more.
Estrogen and clotting disorders
Estrogen, which is found in some oral contraceptives, may increase the risk of blood clots. Talk to your doctor before taking this medication if you have a personal history or family history of clotting disorders
- The Merck Manual Home Health Handbook: How Blood Clots
- National Hemophilia Foundation: Clotting Disorders
- March of Dimes: Thrombophilias