Positive Antinuclear Antibodies - clinic result

[GandTisgoodforme]

Hi,

Has anyone had a positive ANA result during screening? My Antiphospholipid came back fine, as did our chromosomes. Been trying 3.5 years, had chromosomal abnormal pregnancy (first ever pregnancy) in October (TFMR) and no success since. Got endometriosis as well.

The consultant letter was quite unhelpful in regards to the positive ANA, and just requested a redraw in a month or so. It also said that once I am pregnant, to take aspirin once viability had been confirmed.. that’s all well and good but I can’t get pregnant that easily!

Any one else had experience of this, and what was the outcome?

Sorry if this is the wrong place to post.

I had this a few years ago and was down to suspected lupus which was triggered by medication I was on at the time and so did clear up naturally and recent AMA results have come back fine however I take clexane as part of my IVF protocol from ovulation through to BFP/BFN

My one successful pregnancy I had to take clexane for the full 9 months and 3 months after and also baby aspirin from week 20 to about week 36 I think

Hi @itwasalovelydreamwhileitlasted

Thanks for posting, if you don’t mind me asking, what is clexane? Did you conceive naturally with high ANA?

My pregnancy happened cycle 2 after surgery for endometriosis so I’m starting to think that maybe there’s a connection with the endometriosis and raised ANA. I’ll be honest, mad thoughts and desperation are kicking in and I’m prepared to try whatever I can to have a healthy little one!

Endo and AMA aren't linked that I know of. ANA is related to autoimmune problems and of those related illnesses blood clotting can be a problem

Clexane/inhixia are self injecting medicines which are blood thinners and so can help reduce the chance of blood clotting causing miscarriage. I had a miscarriage at 12 weeks for which they found no cause at the time but when I made it to 12 weeks on my second pregnancy they put me on aspirin and clexane and I had a healthy baby

After DC1 I went on to have several more miscarriages and wasn't taking any medication then - when we moved on to ivf the doctors straight away said I would be put on blood thinners and also prednisolone which is a steroid which helps reduce the immune system to stop an auto immune disease fighting a pregnancy - I've not long had another BFP with IVF following this new regime x

I have endo and a very high ANA (1:2560). No autoimmune problems otherwise. There is some research showing that women with endo often have positive ANA. There’s also studies linking ANA with recurrent miscarriages.

Because I have no other antibodies (they have tested me for everything under the sun as I’m so strongly positive), both my rheumatologist & infertility specialist aren’t especially bothered at this stage whilst we have endo to focus on. I also got the “take aspirin” advice.

Have they gone on to test you for SLE?

Hi @pinegreen
Thanks for your reply! At least I know I’m
not going insane and the endo correlation may have something to do with it after all..
Yeah my ANA titer result is similar to yours... I just cannot conceive very quickly basically, and weirdly after my 3rd surgery for endo, I did manage to conceive 2nd cycle post op but he was very poorly and had T21, bearing in mind I’m 28 and he was the only pregnancy I have had after almost 4 years of no contraception and trying!

They’re doing a retest in August, but I’m on the verge of self medicating if the results are still positive and the doctors don’t help me sort things out. I literally have no signs of auto immune disease, hence why they don’t seem interested. I’m at a loss of what to do, as they think the ANA has no bearing on anything fertility wise, but I beg to differ!

Are you seeing a fertility specialist as they would consider ANA as having significant impact on conceiving and staying pregnant?

self medicating is tricky - you really need clexane and steroids and these aren't available without either a doctors prescription or via an ivf clinic

Hi @itwasalovelydreamwhileitlasted thanks for your replies

Yeah I’m finally going to see a fertility specialist next week, so will explain to them about it all and see what they say. The doctor who did my AnA was an obstetrician at the recurrent miscarriage clinic and didn’t seem overly bothered about it all.

I will see if the fertility doctor will prescribe me some steroids and Clexane.
My thrombin time was slightly out as well I believe, 13 seconds and it should’ve been between 15-18. Although I think different hospitals have different ranges.

I’m pleased to hear that you’ve had a successful IVF with the drug regime, that’s reassuring! Hope all goes well with your pregnancy xx

@GandTisgoodforme it sounds like I’m a bit behind you as I’m about to have a laparoscopy to treat the endometriosis, as like you I’m not getting out of the starting blocks and conceiving in the first place.

As I’m a bit older I only waited 6 months (after 7 cycles of very diligent attempts to conceive!) before we did private investigations as endometriosis runs in the family. I’m more or less asymptomatic for endometriosis & never considered I might have it previously.

The ANA stuff was pre trying to conceive. The reading around endometriosis that I’ve done to date seems to suggest that it causes an inflammatory, hostile environment. How that connects to ANA I can’t yet square up but if you google ANA, endometriosis and pregnancy there’s a lot of research studies to read.

This has been a really useful thread particularly the advice on steroids for IVF.

@pinegreen
Hope the Laparoscopy goes well!

It’s rather frustrating to think there’s potentially a very simple treatment/management plan for positive ANA, yet some doctors just don’t want to do much about it. I’m keeping everything crossed that the fertility doc helps me out next week. I’m not holding onto much hope that the ANA has reduced on my next redraw, as like you, my result was very high.

I had a google around after your first post, and I can see some studies that correlate with the endometriosis and positive ANA, which would lead me to think that my last surgery had allowed me to fall pregnant with my son, due to less inflammation and a less hostile environment for embryos!

I’ll keep the thread updated about my appointment if anything happens, as it may help you and others if you are facing similar problems.

Hashimoto's thyroiditis comes to mind, OP.
And of course, SLE.
I have incomplete Lupus, diagnosed in my early 40s.
I'd get a thorough rheumatology panel done and endocrinology/thyroid panel as well.

Hi @TheVanguardSix

Thanks for your suggestions :-)
I don’t think I have any symptoms of any specific autoimmune disease, but I’ll have a look at hashimoto’s. I don’t have any signs of SLE. I don’t have any weight issues which would point towards thyroid symptoms, if anything I struggle to keep weight on nowadays.
I’ll ask my doctor for a thyroid and endocrine panel x