The truth about Clexane and fertility
Clexane injections during fertility treatment? Controversial. Some research says Clexane helps women to conceive. Others question the benefits. So what’s the deal with Clexane and fertility treatment? Time for a closer look at the evidence.
Clexane is a blood thinner, or anti-coagulant. It comes in different strengths. Its active ingredient is a substance called enoxaparin. Clexane is used routinely in general medicine to stop blood clots. Think deep-vein thrombosis (DVT), pulmonary embolisms and bed-ridden patients who don’t move much.
Clexane is a class of drug called a low-molecular-weight heparin (LMWH). Other brands include Lovenox and Fragmin. In fertility treatment, Clexane is sometimes prescribed after recurrent miscarriage and implantation failure.
Clexane is certainly needed when there’s a high risk the blood might get too thick. High doses of synthetic estrogen, common in fertility cycles, may cause this. So can a known blood-clotting disorder, like Factor V Leiden or Anti-Phospholipid Syndrome.
You’ll probably start taking your daily Clexane injections on your embryo transfer day, or from five days before. But your clinic might even start them on day 1 of your stimulating medication. 20 mg daily is common. Doses of 40 mg can be used, though not much higher.
If recurrent miscarriage is the issue, Clexane is thought to help prevent blood clots from forming in the embryo and placenta. It may also increase the production of substances involved in successful implantation, thus tackling any immunological causes of recurrent miscarriage. In both areas, the jury is out on Clexane’s true value.
A notable early champion of Clexane is fertility specialist, Dr. Gavin Sacks. He developed the Bondi Protocol for use by women with repeated IVF failure or miscarriage. The approach combines Clexane with the steroid Prednisone. Injections continue until at least 12 weeks gestation. The research suggests a 53% pregnancy rate. We still see that combination, Clexane and Prednisone, in many of our patients’ protocols.
A study published in January 2015 found encouraging evidence that regular Heparin (not low-molecular) can help to treat recurrent implantation failure. Another study found no evidence that Heparin could help with IVF success. And one from 2018, looking specifically at non-thombophilic IVF patients, drew a blank too.
Finally, a systematic review, published in the Human Reproduction Update, looked at various studies into low-molecular-weight heparin. It found it improved live birth rates by 79%. But the number of participants involved was quite small. As it often is for fertility add-ons. We predict more substantive evidence in the future.
Should you ask your fertility clinic about Clexane? Maybe – if you’ve experienced problems getting or staying pregnant. Possibly – if immune issues have been identified. Definitely – if you have a blood disorder or other qualifying problem. Your clinic should know what to do anyway if you’ve been full and frank in your medical questionnaire.
As for administering Clexane, it comes in pre-filled syringes. Like Menopur and Gonal-f, you injected subcutaneously into your lower abdomen. Some of our patients say Clexane injections are painful. They’re certainly notorious for bruising, so it’s worth asking your clinic how to minimise this. Our top tip? Ice cubes, before and after you inject.
M.
I didn’t have any indicated symptom of blood clot. My phospholipid test and lupus anticoagulant test were negative but my DR still prescribed Clexane (daily dose of 400 mg) plus aspirin. Despite transferring the best grade (5AA) of embryo I still had a miscarriage at 5 weeks. Any advice whether I should take Clexane during my next embryo transfer? The DR who gave a second opinion said using it without any indicated symptom might result in an opposite outcome and he commented that this is a dangerous drug that could cause bleeding in the brain.
Paula Fletcher
After 3 miscarriages in 2020 I went through blood tests and was found to have antiphospholipid Syndrome (blood clotting disorder).
Pregnant again now in may 2021 currently 8 weeks and ive started taking clexane 40mg and asprin 75mg as soon as I had the faintest positive (around 3 weeks pregnant). Everything looking good so far, had a scan at 7 weeks.
I have heard lots of success stories and clexane sounds like a miracle drug!
Jo
Hi, congratulations!! I have had a similar past. How long are you told to take aspirin and Clexane injections?
Thanks
Rimsha
Hi my first pregnancy was intera utrine death due to placenta abruption my blood pressure was high n iugr baby now in second pregnancy my dr start clexane 400mg n asprin 150mg
Shannan
I’ve been advised that I can stop taking clexane 40mg when I hit 12 weeks (in 1.5 weeks). Though I can see a lot of women used it until labour… I am worried if I stop it may cause issues – anyone else stopped after first trimester ??
Tamara
Hi did you stop taking your celexane in the end?
I stopped taking it with my 2nd son at 12 weeks but my consultant said I shouldn’t of stopped it
TAZ
Hi
I have had 2 miscarriages in the past & 1 successful ivf pregnancy where i used clexane until a day before labour
Last month tried home insemination and got a positive pregnancy result but ended in a chemical pregnancy.
Done home insemenation yesterday again. Do i use clexane now to help with implantation or when a positive pregnancy result is received?
Andreea Tanasa
Hi,
I have the same problem, 3 miscariages and now I take Clexane injection every day. Now I have 32 weeks.
My question is how you did delivery? Natural or cezarian and how many weeks did you rich?
Thanks
Vanee
Hi, i took clexane on my 12 weeks pf pregnancy until one day before my delivery. And i also consume aspirin as my Doc’s suggestions.
Clexane due to my recurrent miscariage of 3 times.
Najmul
Hi ,
My wife has 3 times miscarriage. NOW After 4th time conceived our IVF doctor prescribed clexane 40 mg injection daily and Pregnyle Once Weekly.
Wife is 5wk + pregnant..So I want to to how many days to take both injection and is it safe and avoid miscarriage problem
Allana
I took it during my pregnancy and ended up having premature loss. I’m glad o won’t be on it next time. It’s the only thing that my consultant to attribute to why I went into labour. It’s useful if you have a clotting disorder, but otherwise I strongly believe more research is needed on the link if clexane and pregnancy.
Luciano
After year of marriage uncontrolled relations we started to try fertilization, that took many attempts and just when my wife used Clexane she got pregnant of twins. After the babies were born we didn’t care about protection, as we knew she would “never” get that luck again. At some time (2 years) she had a thrombophlebitis and the doctor prescribed Clexane again, and what happened? She got pregnant again, without any treatment except Clexane. After the big news I ran for a vasectomy !
Titi
Hi I have done about 4 embryo transfers using DE. In two of the transfers I got pregnant but miscarried. They suddenly just stop. This time I was on both clexane 40 and aspirin. It sounded a bit too much. I am prone to thrombophilia but not V Leiden. I found my self in the night I wasn’t able to breathe kind of like a panic attack. Also I was having really bad contraction of the uterus a week after clexane and had some sort of orange fluid leaking.
peace
hi i need to know how many dose does a person need to take?
Rita
I am going through DE transfer treatment and have been prescribed Clexane amongst other meds. I have a blood clotting deficiency meaning my blood doesnt clot quick enough so blood thinners are a big no no for me. discussed with my IVF doctor and she maintains i should just follow the treatment protocol which feel to me as a “one size fits all” approach. Due to issues ive had in the past i am reluctant to start clexane but also dont want to mess up this treatment. any advise would be appreciated.
Karra L Schultz
Doesn’t sound like your dr should have done this. What is your update?
Laura
I struggle massively with administering the fragmin. Why can’t it be produced using a smaller, thinner, user friendly needle?
Arunasrinivas
I’m taking clexane after embryo transfer but no progesterone was prescribed. Will be a problem if progesterone is not taken
Samantha
Hey did you have a succesful pregnancy. I have miscarried 3 times and now on my 4th pregnancy and just started clexane 20mg
Katrina
A tip for using clexane from my hematologist – press really hard on the injection site. It minimizes the bruising