Do you have Sticky Blood (APS) and is it Affecting Fertility?

What is APS or Sticky Blood?

APS is antiphospholipid syndrome.

In APS, the body produces antiphospholipid antibodies that interfere with normal blood clotting. Antiphospholipid syndrome causes the immune system to make the blood more prone to clotting, which is why it is often referred to as “sticky blood.”

It can be effectively treated to improve implantation and reduce the risk of miscarriage or pregnancy complications. But first it needs to be identified via blood tests.

Could You be at Risk of APS?

You may have elevated antiphospholipid antibodies if you have:

• A history of implantation failure/negative pregnancy tests

• Unexplained fertility issues

• A history of miscarriage

• IVF implantation failure especially after PGTA tested embryos were chromosomally normal and/or you produced a ample amount of eggs/blastocysts.

• Problems in previous pregnancies such as pre-eclampsia

• A Chinese Medicine Diagnosis of Blood Stasis (heavy periods, blood clots in menstrual bleed, dark blood, brown spotting, strong period pain, fibroids or endometriosis)

What Types of Antibodies are Related to APS?

The APS antibodies include:

• Lupus anticoagulant

• Anticardiolipin antibodies  (IgG, IgM)

• Anti-beta 2 glycoprotein I antibodies (IgG, IgM)

  
  

They can be related to:

• Implantation failure

• Recurrent miscarriage

• Pregnancy complications such as pre-eclampsia

• APS can cause low platelets (thrombocytopenia)

How Do You Test for APS?

You can request APS blood tests from your fertility specialist or IVF clinic. If you are trying to conceive naturally, you can obtain APS blood tests from the NHS if you have had 3 miscarriages as it forms a part of the recurrent miscarriage testing procedure. To diagnose APS, you would usually need two blood tests at least 12 weeks apart. However, most fertility specialists will treat the antibodies if one or more of them are elevated, even without repeat testing.

If you wish to source these test privately, you can utilise the following clinics in the local area:

• One Day Tests, Edgbaston, Birmingham:

  Anticardiolipin antibodies IgG and IgM £110

  Lupus anticoagulant £150

  
  

• Randox Health, Birmingham

  Each antibody test would be ordered separately with the prices not published on their website. It is likely to be around £250 for the full panel.

  
  

  The elements of the APS Core panel and how they affect fertility are listed below:

1. Lupus Anticoagulant

This is a functional clotting test that detects antibodies interfering with phospholipid-dependent coagulation.

Result: positive or negative.

2. Anticardiolipin Antibodies

This test measures antibodies against cardiolipin.

It is usually reported as:

IgG

IgM

3. Anti-Beta 2 Glycoprotein Antibodies

This tests antibodies against the beta-glycoprotein, which is also measured as:

IgG

IgM

What are the Different Levels of APS?

Specialists often categorise patients based on antibody pattern:

• Single positive – one antibody type

• Double positive - two antibody types

• Triple positive - all three antibody types

  
  

Triple positive APS would include positive antibodies tests for lupus anticoagulant, anticardiolipin and anti beta glycoprotein.

This is the highest clotting risk.

Even if you have a single positive you may be given treatment to support implantation from your fertility specialist.

How Does APS Affect Fertility?

1. Recurrent Miscarriage

This is the most common fertility issue with APS.

• Typically occurs after 10 weeks, but can happen earlier.

• Doctors often test for APS after 2–3 unexplained miscarriages.

• Clots can form in the placental blood vessels, preventing oxygen and nutrients from reaching the embryo.

  
  

2. Implantation Failure

APS antibodies may interfere with embryo implantation in the uterus.

This can lead to:

• repeated IVF implantation failure

• difficulty maintaining very early pregnancy

  
  

The antibodies may affect:

• uterine lining

• placental development

• early embryo blood supply.

  
  

3. Early Pregnancy Loss

APS increases risk of:

• chemical pregnancies

• very early miscarriage

4. Placental Problems

Even when pregnancy progresses normally at first, APS increases risk of:

• Placental insufficiency

• Restricted foetal growth

• Premature birth

• Stillbirth

  
  

5. Pregnancy complications

APS is strongly linked to:

• Preeclampsia

• Placental abruption

• Blood clots in the Mother such as Deep Vein Thrombosis.

  
  
  
  

  APS Can Be Effectively Treated

With treatment, most people with APS can have successful pregnancies.

Your fertility specialist is likely to prescribe:

• Low-dose aspirin

• Blood thinning injections such as heparin or clexane

  
  

These medications reduce clotting in the placenta.

Success rates with treatment are high.

Other Immune Tests for Fertility

Here are some other reproductive immunology tests that your clinic may request that you get in addition to the APS blood panel:

Level 1 Immunology - Basic Auto-Immune Screening

Typical tests include:

• Anti-nuclear antibodies ANA (indicates broad autoimmune activity)

• Extractable nuclear antigen antibodies ENA (specific antibodies for autoimmune conditions)

• Anti-dsDNA (a more specific antibody test)

• Complement levels (C3, C4) 

  These proteins are part of the immune system and can appear low when the immune system is actively consuming them, for example in cases of auto-immune disease.

• Rheumatoid Factor (linked to rheumatoid arthritis)

• Thyroid antibodies (anti-TPO, anti-thyroglobulin)

  These test for autoimmune thyroiditis.

  
  

  Level 2 Immunology - NK Cell Testing

  
  

  This is a test for Natural Killer cells which is an important part of the immune system and can affect implantation.

  Here is a separate article regarding NK cell tests: Are Your Natural Killer Cells Preventing Implantation?

These further immunology tests (level 1 and level 2) require a different medication to elevated APS antibodies. Have a look at the above article for more information.

I hope this gives you further options for testing if you think that you may need to explore this area of fertility investigation and treatment.

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