Thrombocytopenia

Thrombocytopenia means that you have a low platelet count. Platelets, or thrombocytes, are blood cells produced by the bone marrow that help your blood clot. Not having enough platelets makes it harder for your body to stop bleeding.

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Impact of thrombocytopenia on fertility

Thrombocytopenia itself doesn’t affect your chances of conceiving. However, some of the causes of low platelets can impact fertility, so be sure to get an in-depth checkup to find out what is decreasing your platelet count and begin targeted treatment if necessary.

During pregnancy, having too few platelets can lead to premature labor and a slight risk of increased bleeding during delivery. It can also prevent you from being able to get an epidural or deliver via cesarean section. Antiphospholipid syndrome (APS) is a potential cause of thrombocytopenia and can increase the risk of miscarriage and stillbirth.

Potential causes of thrombocytopenia

A low platelet count has 3 potential causes: either your bone marrow isn’t producing enough of these cells, your spleen stops platelets from circulating through your bloodstream, or your body is destroying platelets.

Thrombocytopenia can be due to the following:

• Bacterial or viral infections
• Vitamin B12 or folic acid deficiency
• Certain medications (e.g. ibuprofen, heparin, antibiotics, seizure and heart medication)
• Surgery
• High alcohol consumption
• Exposure to toxic chemicals, such as pesticides 
• Autoimmune conditions (e.g. lupus, rheumatoid arthritis, immune thrombocytopenia, antiphospholipid syndrome)
• Cancer treatments
• Blood cancers (leukemia or lymphoma)
• Enlarged spleen
• A disorder that makes blood clots form in small blood vessels
• Myelodysplastic syndrome (a condition in which the bone marrow doesn’t produce enough blood cells or makes irregular cells)
• Aplastic anemia (a blood disorder where the bone marrow stops producing enough new blood cells)

Certain pregnancy complications, including preeclampsia and HELLP syndrome, can also cause thrombocytopenia.

Symptoms of thrombocytopenia

In many cases, thrombocytopenia doesn’t have any symptoms. But as the platelet count decreases, you may experience:

• Heavy periods
• Nosebleeds
• Easy bruising
• Bleeding gums
• Blood in poop, urine, or vomit
• Red, purple, or brown spots on the skin
• Fatigue

Rarely, severe thrombocytopenia can cause dangerous internal bleeding.

Diagnosis of thrombocytopenia

Doctors diagnose thrombocytopenia with a physical exam and various tests. A complete blood count (CBC) checks your levels of different blood cells. During a blood smear, a healthcare provider looks at platelets under a microscope. You may have a blood clot test, which determines how long it takes your blood to clot. Finally, you may get a biopsy of your bone marrow.

Treatment to improve fertility

People with mild thrombocytopenia (which is the case most of the time) usually don’t need treatment, just observation. Ask your doctor what your low platelet count means for you and how it may affect a future pregnancy. If your thrombocytopenia is due to an underlying medical condition such as an autoimmune disorder, your doctor will create a treatment plan for the root cause.

When needed, doctors commonly prescribe medication (corticosteroids) to increase the platelet count. In rare and severe cases, healthcare providers may recommend a blood transfusion or surgical removal of the spleen to treat thrombocytopenia.

Eating more of the following foods can also help boost your platelet count:

• Dark chocolate
• Dark, leafy green vegetables
• Eggs
• Fortified breakfast cereals and dairy alternatives
• Vitamin C-rich foods, including oranges, Brussels sprouts, and red bell peppers
• Black-eyed peas
• Lentils
• Lean beef and beef liver

On top of that, make sure you are taking your prenatal vitamins because they contain folic acid and vitamin B12. These are important for both platelet production and the baby’s development. 

If you drink a lot of alcohol, know that this can decrease platelet levels and affect fertility. No amount of alcohol is safe for a growing baby, so all women trying to conceive are recommended to stop drinking completely.

It’s common for the platelet count to go down during pregnancy because of normal changes in the body. Treatment for thrombocytopenia during pregnancy is usually not necessary unless the platelet count drops to dangerously low levels. The platelet count usually returns to a healthy level on its own after delivery.

This article has been verified by a medical professional

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• Thrombocytopenia. MedlinePlus – National Library of Medicine. Accessed 23 November 2022.
• Thrombocytopenia. National Heart, Lunch, and Blood Institute. Accessed 23 November 2022.
• Thrombocytopenia (low platelet count). Mayo Clinic. Accessed 23 November 2022.
• How can having low platelets affect my pregnancy and birth plan? UT Southwestern Medical Center. Accessed 23 November 2022.
• Patient education: Antiphospholipid syndrome (Beyond the Basics). UpToDate. Accessed 23 November 2022. 
• Mangla A and Hamad H: Thrombocytopenia in Pregnancy. StatPearls [Internet]. 2022.