What is APAS?

As of February 2014

You miscarry once and the world crashes down on you. You promise to do all things right the next time like go to bed early or eat the right food and so on, and then, for the second time, you lost your little angel again.

While drowning in the effects of the epidural, I could barely muster the words, “What happened?”

According to my new perinatologist, Dr. Valerie Tiempo-Guinto, there are several reasons why women miscarry. I will try to enumerate what I can remember:

  1. In most cases, it is caused by chromosomal abnormalities in the developing baby.
  2. Infections
  3. Biological problems (polycystic ovaries, etc.)
  4. Environment (smoking, unhealthy lifestyle)
  5. Repro-immunological problems (as mentioned)
  6. Unknown

To quote from Reproductive Immunology Associates, one in every 200 couples are too genetically similar to achieve a successful pregnancy. They are saying that one among 200 couples will experience two or more recurrent miscarriages. That is way higher than the incidence of parents giving birth to children with Down Syndrome (1 in every 800) and children with Rare Disorder (1 in every 20,000). I am comparing this to the latter because I have also been involved with PWD causes.

In cases of recurrent miscarriages, 50% can be contributed to repro-immunological disorders. Miscarriages are devastating, but with proper information and prevention coupled with a lot of prayers, there is hope for all of us who direly want to have a little bundle of joy in our arms.

When I was ready to face the situation, I was informed that I have APAS or Antiphospholipid Antibody Syndrome. When I asked initially about what it was, it was explained in a very generic way like how our antibodies fight things even the fetus and what-not. I was told to wait three months; there should be a work up and all the shebang.

But what REALLY is this APAS? 

My first visit to my immunologist, Dr. Carol Tolosa-Gloria, lifted the many questions that I had in mind. She was able to explain to clearly, not considering the fact that I was bad in biology back in college. The following are adaptations of the short lecture she gave me and my husband as well as in the brochure that you can find in her clinic.

Recurrent miscarriages may be attributable to APAS in most cases than not. However, APAS forms only one of the five categories comprising the repro-immuno disorders. According to Dr. Gloria’s brochure, and I quote –

“The body’s immune system defends against infection and plays an important role in cancer, auto-immune diseases, aging, pregnancy, infertility and miscarriage. An immune system problem may be the cause of some cases of unexplained infertility, recurrent miscarriages or repeated implantation failure with IVF/IUI. Premature birth, intrauterine growth retardation, early rupture of membranes or distress on delivery can all point to a possible immune cause to a difficult pregnancy.”

There are five categories of immune problems in pregnancy, often occurring together in combination:

  1. The couple’s tissue is too compatible; the woman’s body considers her placenta foreign with her immune system activating against the baby
  2. Blood clotting problems like antiphospholipid antibody syndrome or APAS
  3. An immune reaction to the baby usually indicated by a positive ANA (anti-nuclear antibody) test
  4. The couple produces antibodies to sperm which immobilize and destroy them on contact
  5. Certain white blood cells are over active like the NKs or natural killer cells.

The doctor will determine the immune problem condition based on lab tests for the 5 categories mentioned and treatments will be based on the particular category. I was diagnosed with Categories 1 & 2 (Editor’s note: As of July 2015, I was also diagnosed as Category 5)

After I was diagnosed with repro-immuno disorder, I wanted to know more about it and research on it to be able to share more information as the incidence of its occurrence is quite on the high side. I hope that through this blog, I will be able to help make the condition those who are undergoing the same situation.

PS. If I had known what APAS was all about during my first loss, I would have had my self tested. Spending some money for the test is nothing compared to another heartache or worse, another D&C that you might encounter in the future.

Hugs and babydust to you.

xx,Balot Sign




Note: Last October 4, 2013, I lost my second baby. While I am happy that I have a little angel in heaven, the pain does not really go away. I was talking to a friend the other day about the loss that we feel for a loved one and we agreed that it still does not become easier despite the years.

To celebrate the two months that I have carried my little one, I would like to re-post about APAS and my current condition to hopefully shed some light to those who are suffering from the same disorder. There has been an alarmingly increasing number of people who are suffering from repro-immuno disorder. It is a grueling and challenging journey and I hope that you could send a little prayer along our way.

P.P.S. As of May 2015, I have already given birth to my rainbow baby, Santi, after following treatment and constant monitoring by my doctors. God is good. <3