When a mother loses a baby back in the day, people would often assume that it just wasn’t meant to be. “The baby wasn’t ready”. “The timing just wasn’t right”, “You can always try again”—these were the most common things that well-meaning friends and family would say to someone who had lost a baby. Left undiagnosed, these miscarriages seemed normal, but now that medical advances have finally looked into these unexplained losses, we have a definite yet extremely complicated answer: APAS. Short for Antiphospholipid Antibodies Syndrome, APAS is now the growing cause of recurring miscarriages and difficulty to conceive in most women today.
It may sound like a lot of scientific mumbo-jumbo, but the bottom line is this—APAS makes baby-making a challenge. It requires patience, emotional strength, a hefty medical budget, and a great leap of faith.
I should know—I have APAS, after all.
What is APAS?
In layman’s terms, what APAS basically means is that a person’s antibodies are sort of on overdrive—they sometimes mistake their own body cells for foreign invaders, hence, attacking them. The antibodies attack all foreign bodies—which includes anything related to making a baby.
It’s true that there are a host of other factors that may hinder a couple from conceiving properly. The woman may have Polycystic Ovarian Syndrome or PCOS, Endometriosis, blocked fallopian tubes, and so on. The husband may also have sperm with decreased mobility or high levels of abnormalities, opening up a different kind of infertility. But APAS is one of the most difficult factors to treat, which is why a lot of couples find themselves becoming disheartened.
Characterized by internal blood clotting, unsuccessful IUIs (Intra Uterine Insemination), and failed IVFs (In Vitro Fertilization), APAS brings a whole new meaning to waiting for the stork to come. Most women who have inexplicable infertility might not be aware that they should consult their medical provider for a series of reproductive immunology tests. These tests will help determine if the patient is indeed positive for APAS—at the very least, they can start getting the proper treatment they need in order to make a healthy baby a possibility.
What does it all mean?
There are five categories when a woman undergoes immunological testing. Category I is the Leukocyte Antibody Test (LAT). This means that the body of the woman lacks the blocking antibodies needed to stop your own immune system from rejecting your baby. When the DNA of the wife is similar to the DNA of the husband, the body fails to form a protective shield around the fetus, exposing it to the attack of your own immune system. Lymphocyte Immunization Therapy or LIT helps treat this condition by having the husband’s blood plus other donors’ blood injected into the wife. This is why the love, patience, and support of the husband is tremendously important—even more than in normal pregnancies—when a couple has APAS.
For Category II, the proteins in antiphospholipid antibodies glue themselves to the body’s cell membranes. Because this becomes all sticky and forms blood clots, the blood then fails to flow properly, putting the baby at risk. These antibodies attack the placenta and endanger the life of the baby. Most women with Category II often take aspirin or do self-injections of heparin into their bodies as blood thinners or anticoagulants.
Antinuclear Antibodies (ANAs) for Category III concern the nucleus of the cell. They attack the cells inside the womb of the mother and the fertilized egg, hindering implantation and causing a miscarriage. As for Category IV, fertilization itself is blocked because the Anti-sperm Antibodies hold off the sperm of the husband from doing what they do best. And when there are no sperm cells that successfully make it to their destination, there is no baby.
Finally, Category V tells of Elevated Natural Killer Cells or NK cells. Even though Natural Killer cells in our white blood cells are highly crucial for our bodies to conquer bad infections and sicknesses like cancer, when these levels are elevated more than normal, they become aggressive and fight off pregnancy as well. All these sound too overwhelming because they are—and more and more women are going through this ordeal every day.
What should you do?
Undergoing professional treatment for women with APAS is incredibly taxing for both the wife and the husband. The long hours at the doctor’s clinic, the painful injections, the unending series of tests, the sky-high prices of medications—all these add to the fact that not everyone can understand the difficulty you are going through just to have a baby to call your own.
The waiting — the unbearable torture of waiting. This is why APAS warriors often come together and form support groups, because having someone who can relate to you is an invaluable asset when times are tough. These groups also have a lot of APAS mommies who share their success stories in order to inspire those who are still struggling and hoping.
If you suspect that you or someone you love has APAS, consult your family doctor, your ob-gyn, or your reproductive immunologist (if you have one) right away. There are a surprising number of blogs from fellow APAS sisters around the Web, too; you can find out more about how to cope as well as the general overview of costs per treatment in this blog.
I used to think that having a baby was as simple as one: find the love of your life, two: get married, and three: have kids and start a family. But it seems like “happily ever after” only truly happens in fairy tales and Disney movies. Life can be quite tricky sometimes, but you just have to learn how to roll with the punches. So be strong, fellow warrior, and have faith—you precious little miracle will come when he’s ready.