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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Bleeding When On IVF Treatment?

I am a 37-year old woman who is trying to get pregnant with het second child. My husband and I already have one daughther through IVF. Recently it has been discovered that I have a high factor VIII value (211, while the maximum reference value is 150). Because of this I have been advised tot use baby asparin (100 mg) during IVF because this would help implantation of the embryo.

With my last IVF-treatment (augustus 2012) I started on asparin the day after egg retrieval. The day after that I started bleeding (brown blood). The bleeding went on for about a week and then it stopped and sadly one week later I had a negative pregnacy test. During the bleeding epsiode I have been examined with a speculum and it was said that the bleeding was from wounds of the egg retrieval. The asparin caused my wounds to heal slower and bleed longer. So far, a good explanation. But now comes my problem

In my own natural cycle after the failed IVF-treatment I also took baby asparin. I started on day 11 of my cycle and I bled (brown blood) up untill day 25. Then the bleeding became heavier and red instead of brown: the start of my period. I stopped taking asparin when my period started. During this last cycle I wasn't examined nor did I have intercourse. So there hasn't been any contact with my cervix. How can it be that I have (brown) blood loss when taking asparin?

Also I use insulin (because I'm a diabetes type 1 patient and therefor insulin dependent). Can the combination with asparin cause the bleeding?

And with my next IVF-treatment the plan is that I'm not only to use asparin but also fraxiparine (similiar to clexane). Frankly I'm scared of the potential bloodbath. Considering the effect asparin has on me is this advisable or is brown blood loss no problem? Or should I stop all together with anticongluants trying to conceive. I stress that I am only advised to use anticongluants trying to conceive. In "normal" life my doctors don't consider it necessary for me to use anticongluants to avoid trombosis.

Any word of advice/explanation on this bleeding issue would be much appreciated.
Mon, 3 Jul 2017
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OBGYN 's  Response
You start aspirin after conception that is after confirming cardiac activity of the fetus.
Also low molecular weight heparin after 28 weeks of gestation.
As you are having condition which can predispose you for thromboembolism that means blood clotting and moving of blood clot to vital organs and causing problems its essential you take these medications.
Now regarding your diabetes continue your insulin however make sure your Hb A ic level prior to pregnancy is below 6%.
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What Causes Bleeding When On IVF Treatment?

You start aspirin after conception that is after confirming cardiac activity of the fetus. Also low molecular weight heparin after 28 weeks of gestation. As you are having condition which can predispose you for thromboembolism that means blood clotting and moving of blood clot to vital organs and causing problems its essential you take these medications. Now regarding your diabetes continue your insulin however make sure your Hb A ic level prior to pregnancy is below 6%.