If you have FH and want to become pregnant: read this!

Trying to get pregnant can be stressful enough, not to mention if you are managing a health condition. According to the Mayo Clinic, FH (familial hypercholesterolemia) is “an autosomal dominant disorder characterized by a high plasma level of low-density lipoprotein cholesterol (LDL-C).” 

Here are three quick reminders about FH:

1. FH is common— about 1 in 200 people have it.
2. FH is underdiagnosed—90 percent of those with FH do not know it.
3. FH is treatable — with safe medications and diet and lifestyle changes, FH patients can live a normal life.

But, FH is also associated with dramatically increasing a woman’s lifetime risk of gaining premature atherosclerotic cardiovascular disease.

If you have high cholesterol or know you have FH, Dr Sophocles suggests you find a good doctor, get educated, know your risks, and know your options. The FH Foundation is a great resource.

Here is Dr. Sophocles’ list of nine important things a woman should keep in mind if she has FH and wants to get pregnant. 

1. First and foremost: FH is not a contraindication to pregnancy. Women with FH can, and should, have the family they want! 

2. Know your history with FH. Do you have vascular disease? Are your lipids controlled? Have your family members been tested? Women should be checked for aortic stenosis and know, prior to pregnancy, whether they have evidence of atherosclerosis. Women with FH should have their pregnancy co-managed by their OB-GYN and a cardiologist. 

3. If you are on statins, stop them three months before you try to conceive. If you do conceive while on a statin, stop the medication and let your OB-GYN know you were on a statin at the time of conception.

4. Do not check your lipid profile while you are pregnant! Lipid levels rise during pregnancy in all women and doctors almost never suggest treatment because it is a temporary elevation.

5. If your doctor wants you to take a cholesterol lowering medication during pregnancy and/or breastfeeding, you can use a class of medication called resins. Resins do not enter the bloodstream, so they are safe for use while pregnant and breastfeeding.

6. Women with FH need to stay fit. They already have a risk factor for heart disease, so they should eat heart healthy foods and maintain a healthy weight. Health and longevity for FH patients, like all women, is more than just cholesterol levels. 

7. Exercise is a great way to support your maintenance of a healthy lifestyle. A blend of weight training and cardio can help you stay mentally balanced as well, which can ease some of the stress you may be experiencing. 

8. On that note, my eighth recommendation is about stress! Understanding that women with FH and controlled lipids have no increased risks for pregnancy complications should be reassuring.

9. To reduce anxiety about conceiving a child with FH, your partner should have a lipid screen. If it is normal, it is very unlikely your partner has FH and, in that case, your child will have a 1 in 4 chance of getting FH in heterozygous status. If your spouse, partner, or sperm donor has elevated lipids, he should be referred for genetic testing and you both should speak with a genetic counselor to understand the probability of having a child with FH.

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