In the late 2020 during the Covid pandemic, my Husband and I decided we want to get pregnant again. We already had to come to terms that we would be facing a difficult pregnancy after losing 2 pregnancies in 2019 and having been diagnosed with Reproductive Immune Disorders.
APAS is one of the five Reproductive Immune Disorders and the most common abnormal immune system problem. For women trying to conceive, it can prevent implantation thus preventing pregnancy in the first place. It may also prevent the pregnancy to progress causing miscarriage and fetal death. When I went to Bloodworks Katipunan to have run the diagnostic tests requested by my Immunologist, Dra. Lara Aleta, I was hoping for the best and not have APAS or any other RID’s, but I was not spared.
In November 2020, we found out that I have APAS: I was positive for RID’s Category 1, Category 2 (APAS) and was also Vitamin D deficient.
As soon as we found out the diagnosis, we had to take a quick step backwards to swallow all the information in and mentally prepare ourselves for the battle ahead. And boy was it a battle indeed! It was in thmiddle of the pandemic and treating APAS would be a challenge. We had to do online consultations with our doctors and went only to the clinic for tests and treatments. Building our relationship with our medical team via online interaction was hard but had to be done that way.
Treatment we had to go through
We started our treatment the week after we found out about the diagnosis. My husband became my (blood) donor and after getting him cleared for blood donation. My treatment was LIT, Lymphocyte Immunization Treatment, to increase my antibodies to block/stop my immune system from attacking the pregnancy. We would go to the clinic before 7AM for the blood extraction and the treatment would be at 10-11 AM. A blood sample is taken from my husband every treatment. The sample is then processed in the lab on the same day with the white blood components left. It is then injected in my arm, subcutaneously (under skin). To my understanding, it slowly allows the my body to get use to and identify my husband’s blood components as, somewhat, my own. The treatment is done every three weeks until my LAT, Lymphocytes Antibody Test, scores reached the level safe for pregnancy.
Prior to treatment, my Immunologist told us that we have to increase my LAT scores before we try to get pregnant. It took us four LIT sessions before we were reached LAT scores that was safe for me to get pregnant and before we were given the go signal to try to conceive.
Medications we took prior to getting pregnant
Before we started APAS treatment, we went to see my OB-Perinatologist to inform her the diagnosis and asked if there were any additional management she wanted us to do. She told me to continue taking my prenatal vitamins and folic acid. She also added to she her as soon as I get pregnant or suspect that I am. And to see her if if we are unable to get pregnant when given a go signal to TTC by the Immunologist.
Our Immunologist prescribed us to take CoQ10 on top of our multivitamins and other supplements. She did not prescribe probiotics, she encouraged me to increase my probiotics with Yakult drink and to be mindful of what I eat. Before getting pregnant, I was taking prenatal meds, Folic Acid, Vitamin D, Vitamin C + zinc and CoQ10. I would take this religiously spread throughout the day.
Lifestyle before and during APAS treatment
Before we decided to start with APAS treatment, my husband and I were already decided that we will try to get pregnant again. Like my previous pregnancies, we took a healthier approach prior to TTC. On the third pregnancy, we exercised by doing daily walks of 1-2H a day. We would hit 10,000 steps or more each day. This not only gave us a fit body but also helped us lose weight. We also lessened caffeine and sugar intake by taking out the foods and drinks we usually go for. It was also important for us to go to bed early. We did this so we can have longer sleep time and be well-rested. On my case, I lessen my work hours by dropping my second client. So instead of working full-time, I was only working four hours a day.
Knowing my body cues and ovulation period
I also took this time to know more about my body. I would take notes on what I would feel and how my body is during ovulation, PMS and my period. I also tracked my menstrual cycle using an app to help us identify my ovulation phase more accurately. So by the time we were given the Go Signal, we already knew my cycle and can identify when I ovulate using the app and also the ovulation symptoms from my body.
Mental and emotional preparation
Reading through other women’s experiences on a support group for APAS women on Facebook, I could only imagine the mental and emotional battle one goes through. So my husband & I researched and read about the experiences of other couples to gauge how it would be for us. We knew that the treatment was not an assurance of successful pregnancy and that we’d have a challenging pregnancy if the treatment is successful. Either way, we knew that it would be a mental and emotional battle for us. Preparing and psyching oneself helped us better deal and navigate through the rough parts of the journey. So when we got pregnant and was told to stay in bed, for most of my first and second trimester, I was mentally in a much better position to accept the pregnancy difficulty.
When we were finally given the go signal to try to conceive, it was easier for us to identify my ovulation period. My body was also fairly healthier and more fit to withstand the months of lying down mostly in bed. The vitamins and supplements I took also helped boost my immune system with no flu or even threat of flu in the whole duration of the pregnancy. There was mental and emotional struggle still but it was not going-crazy kind of way. I have learned to focus my energy in prayer when the rough times hit. It was a way for me to surrender myself, my body, the pregnancy and the baby to our Almighty Lord for everything else is beyond my hands and control.
There are a lot of things one can do to better their chance at getting pregnant and in keeping the pregnancy. And while it is good to research about your condition, it is best though to seek professional help. We can only do so much from our own strength, research, and resources.