What would be your approach to a SLE patient who is triple APS positive, has no prior VTE/obstetric events, is stable on HCQ and low dose aspirin, and wants to become pregnant?

As long as lupus is well controlled, I would not recommend making any changes. I would also reassure this patient that having prior successful pregnancies (based on the information provided in the question stating that there were no prior obstetric complications) is a good sign.

I would not prescrib...

Interesting situation. I would probably err on the side of providing low-molecular-weight heparin during the pregnancy. We will of course need to engage Maternal-Fetal Medicine specialists. Hydroxychloroquine would likely need to be discontinued.