I really dig the doctor I got at the Maternal-Fetal Health Center. He's got a great sense of humor.

"Well, you're not normal."

*chuckle* "I know that! In what respect am I abnormal today?"

It turns out that I have an abnormality of MTHFR (methylenetetrahydrofolate reductase) called the A1298C mutation. As a matter of fact, I have it on both genes; both of my parents therefore have at least one bad copy. All of the other likely causes of the thrombosis appear to have been ruled out. I do not have an acquired clotting disorder, and I do not have any of the other genetic abnormalities.

This enzyme is part of the processing of folic acid; the abnormality is associated with increased risk of heart disease and stroke (wonder if there's a relationship to the tachycardia I used to have?). Even when
not pregnant or trying to conceive he recommends I take a daily baby aspirin and a daily multivitamin with 400mcg of folic acid.

It is also highly associated with incidence of spina bifida and in later pregnancy with placental insufficiency; high doses of folic acid protect against both. From now until delivery, I am prescribed to take Folgard. Until conception (or say until March/April when we plan to start trying), I should take 1 Folgard every day plus a multivitamin (aiming for 2200-3000mcg folic acid per day) and then start taking two Folgard every day (5200mcg per day).

I'll have to start injections of Lovenox (low-molecular-weight heparin) at 6 wks gestation (must ensure the pregnancy is not ectopic before starting anticoagulants).

His last words to me: "Go get pregnant."

At some point I expect I'll want to have Rosa tested for this condition as well--she obviously has at least one bad copy of the gene--and I'm going to have to let my birth family know about it so they can take whatever precautions they feel necessary.