Miscarriage occurs more often than most woman realize. At least 15-25% of pregnancies will end in miscarriage, and as a woman ages, this percentage increases. Many women are not aware of this high percentage of pregnancies that miscarry and want to understand why it happened and could it have been prevented. We are often asked what testing for causes of recurrent pregnancy loss can be done.
Testing For Causes of Recurrent Pregnancy Loss
Testing for recurrent pregnancy loss includes assessment of possible genetic, anatomic, hormonal, inflammatory, and immunologic causes. All testing can be accomplished within one menstrual cycle with tests timed during the cycle.
Blood Tests for Causes of Recurrent Pregnancy Loss
The timing for testing for causes of recurrent pregnancy loss is an important factor. At the Fertility Centers of New England, we begin testing on Cycle Day #3 by obtaining blood for the following:
- Follicle Stimulating Hormone (FSH)
- Thyroid Stimulating Hormone (TSH)
- Cell Blood Count (CBC) with platelet count
- Blood type and Rh factor should be assessed if not already known
- Testing for Cystic Fibrosis (CF) mutation and immunity to Rubella
- In women with known ovulation dysfunction, we obtain a Fasting blood test on Cycle Day #3 test for glucose and insulin
On Cycle Day #10, we obtain blood again for FSH and do a pelvic ultrasound. From there on Cycle Day #22 a blood test for Progesterone is obtained. We also obtain blood from the couple for chromosomes.
Blood Tests for Pregnancy Losses After 12 Weeks
In cases where pregnancy losses have occurred after 12 weeks of gestation, we obtain blood tests for:
- Anticardiolipin Antibody
- Lupus Anticoagulant (Russell Viper Venom Time)
- Thrombophilia profile consisting of Factor V Leiden, Protein S, Protein C, Prothrombin (Factor II), Anti-thrombin III, Beta-2 Glycoprotein I Antibody IgG
- Homocysteine Level
There is no need to order these expensive tests in cases of first trimester pregnancy loss.
Testing for Problems With The Uterus
An intrauterine structural study to determine the internal uterine contour is performed following menses but before an anticipated ovulation. This tests may be either a Hysterosalpingogram (HSG), SonoHSG, or a hysteroscopy. We often couple this test with an endometrial biopsy to rule out the presence of endometritis.
Role of Male Factor Testing for Recurrent Pregnancy Loss
A semen analysis is of less benefit unless the couple has also had difficulty conceiving, although, poor morphology has been associated with not only difficulty conceiving, but also with very early pregnancy loss (biochemical/aembryonic losses).
At Fertility Centers of New England, our goal is to optimize all aspects of a patient’s overall health in order to have the best possible chance of conceiving. If you are seeking help for recurrent miscarriage, please contact us. We are here to help.
*Your consultation is FREE if you don’t have infertility insurance coverage.