Tests for recurrent miscarriage

Thought this list might be useful for anyone in the recurrent m/c bracket who are undergoing testing. I have had some crap medical care and don't want others to have the same. These are the tests I have had by 3 specialists- please add additional ones if your need to.

* coeliac disease
* MTHFR homozygosity
* anti- beta II glycoprotein
* prothrombin gene mutation 20210A
* anticardiolipin anitbody
* plasma homocysteine
* antinuclear antibodies
* prothromin 3
* protein C
* Free protein S (antigenic)
* RVV test
* Delta KCT
* Lupus anticoagulant
* Factor V Leidin
* Chlamydia
* Mycoplamsa/ ureplasma
* Chromosomal analysis

Great list Meg. Good to see MTHFR listed. I actually have that abnormality and was also told at the time in can cause re-current miscarriages. When i heard that I came here and asked the girls if they have ever heard of it before..

So finding out i had that abnormality and being told i would be lucky to ever have kids cause of Endometriosis I feel extremely blessed

Love :smt049

What a great idea, Meg. Any chance this thread could be made a sticky? I'm sure lots of people would find it really interesting.

The only other test I can think of atm is a TSH (Thyroid Stimulating Hormone) test.

Brilliant, thanks, Meg, now you can just ignore my other post asking you for the details.
Charlotte

Hiya Angel.

I made it an announcement on Thursday for you :)

Love :smt049

I just wanted to add that other routine tests done are those for toxoplasmosis, parvo virus and listeria.

Thanks, Kathryn :D

thanks so much, meg!

i'll be referring to this list in my next check up. my doc really appreciates it that i take time to learn more about my body and the other stuff related to pg.

take care,

This is fantastic!

I must admit, after multiple miscarriages, I have been tested for a range of things, but I have to admit to being a bit norty and leaving it up to the professionals to monitor. I suppose I always thought that "next time" would be ok.

I am going to find out the tests I've had and what the actaul results are. I do know that of all the tests I've had, I have come up "normal" in all of them, including genetic testing of embryos.

Gets frustrating when the tests come back as good, but you still can either get or stay pregnant.

Hayseed

What is MTHFR?

Hayseed

hi all, just got my bloods back from my last m/c. all were normal all except one for blood clotting. which showed an abnormality. My Gp said this can show up during pregnancy or as your age progresses, has anyone else experienced this with there blood and what has been done. I am seeing the Prof in 4 weeks time so maybe get some answers as to why?
Just another hurdle to get past.

I wonder if that's the test for antiphospholipid syndrome. There are a few members now who have had that Nola, and have gone on to have babies!! It's a matter of taking a small dose of asprin each day in order to thin the blood.

melinda, thank you so much, i was getting a little worried and called my Dr today and she said the same, And not to worry.

Kathryn ~ I have endometriosis and my Ob Gyn told me that it has little or nothing to do with falling pregnant?

He has clients that are "riddled" with endo and fall pregnant at a sneeze and others with a tiny little bit, that have lots of trouble falling pg.

Is there some new research to show that it does affect conception?

My last pregnancy (which ended in m/c at 9wks) only took 3 cycles.

Kind regards
Beccy

Going through my notes from when we were TTC & PG with Kynan I realised there was a test I had done that I hadn't listed here - antithyroid antibodies. I lot of docs don't test for these if your TSH comes back normal. It's really worth having this test done though as antithyroid antibodies can be present even with a normal TSH, and women with these antibodies can be twice as likely to m/c.

I've had blood clotting with one of my pregnancies and that was only when the gyno told me to try taking asprin. I cant remember all the blood tests I've had done *sigh* the only thing they have been able to find so far was a low level of anti nuclear antibodies, everything else has come up normal.

I have recently been tested for "antiphospholipid antibodies" among other things, thankfully this came back as negative but it is responsible for many miscarriages.

I just had my 4th loss. I am in the recurrent miscarriage program at Sydney IVF. This program involves a cycle of monitoring to try and identify problems. Aside from this b/w there are also multiple u/s, HSG, and endo biopsy, as well as the partner having to give an SA. There is also a chromosome karotype test for both partners.I am posting this in the belief that it may help someone else out there. Everyone I have spoken to in this program is very caring. Do not hesitate to contact them. Here is the list of CD2/3 bloodwork:

Fasting glucose
Fasting insulin
Fastign homocystiene
T-cell subsets
Protein S
Protein C
Anti-thrombin III
APC resistance
FSH
LH
Prolactin
Testosterone
TSH
SHBG
AST
ALT
(I don't know what these last two are - can't remember)

Sometime before CD14 I will also have a b/w panel including:

Tissue transglutaminase Ab
Serum copper and ceruloplasmin
ANA
Anticardiolipin antibodies
Anti Tja antibodies
Thyroid antibodies
Lupus anticoagulant
Immunoglobin A (lgA)
Antigliadin Ab
CA 125
B12 and Folate
FBC
Blood group
Antibodies
Hep B
Hep C
VDRL
Rubella
HIV

Scarlet - Do they have a recurrent mc program in Qld that you know of?
I would defineately check in with them. I'm so tired of not knowing why I cant hold a pregnancy:-(

Hindonly,
Not that I am aware of. I am in Qld though and there are a number of folk that I would recommend you seeing.
Where in Qld are you located (if it's okay to ask)

Flowerchild. I'm located in Brisbane and am currently seeing afertility specialist but feel sometimes that I haven't had enough tests done after 4 mc's:-( Im at that point of needing to know some answers. there must be a reason why! So I have an appointment with him late May so will have a v good chat to him about what more we can do...

:hugs: I know this is really hard my love.

Have you had a little look here

What I would do is to take some time and sit down quitely and write down any little bitty health issue you have ever had. A rash, aching joints, whatever. Write it down. Question your maternal and paternal sides with regard to any of those as well.

Write it all down in chronological order.
Write down each of your pregnancies, experiences in that pregnancy and about the birth of your daughter. Document everything. It's important. It gets it clear for you and it jogs your memory to things that may seem irrelevant at the time but can be very important.

I have discovered that many cases of recurrent miscarriage (of course not all but many) are caused by an immunological issue. I would highly recommend seeing an obstetric immunologist. Firstly though write your history.
If you can get all of your blood work released to you by freedom of information. Take these with you to your appointments.

Don't stick with just one doctor. This is important. No matter how much you like someone you need several opinions. You may go back to your doctor but you need to interview doctors. You need to seek opinions. I made this mistake.

I would highly recommend either seeing Dr G Sacks in Sydney or doing a phone consultation with him. He is an obstetric immunologist and many of the BB women have had wonderful experiences. To make the consult worthwhile though I would seek out face to face opinions first. Tell them you have a time booked for a phone consult (or face to face if you can get to Sydney) with Dr S - this shows you mean business!

Remember you are a health care consumer. You are the customer.
If you need any support or more information I would be happy to help. I truly understand how this feels. :Hugs:

Hindonly, I am sorry I do not. I used to live on the North Coast of NSW so would have looked in Qld at some point, but I am currently living in Sydney. I found the program when looking at IVF sites. I would try that. Although Flowerchild has given some very good advice! :) Good luck. I do apologise that I did not answer your question earlier, I haven't been on here much lately.

I just wanted to add that today I had a genetic panel. This tests for Factor V Leiden, MHTFR, they do a karotyope (I think that is the chromosome one) and there was another genetic test too (can't remember now - Prothrombin maybe??). DH and I both had the same genetic panel. (Yep, they test your partner too).

I have had two confirmed (three probable) very early miscarriages (4-5 weeks) and after speaking to my fertility specialist we are wondering about an implantation process. I plan to have the gammet of bloods for recurrent miscarriages and was wondering if anyone knows how long it takes to get these results back? I'm pretty anxious about knowing if there really is a problem!

Hi Skipping Girl,
Most of the tests have quite a short turn around. The chromosomes (karotype)will take a few weeks...
Wishing you luck with your journey... :hug:

Hi Skipping Girl, sorry to hear of your losses. The bloodwork shouldn't take long, but some of the immune tests like lupus can take about two weeks. It took two weeks for the genetic panel. Istrongly recommend this ---- I was diagnosed with the MTHFR thrombophilia. After three m/c's you should definitely have all these tests run.Wishing you all the best.

What is considered 'normal' for homocysteine levels? I have had 2 miscarriages this year and I had my levels checked Feb 2005 (for unrelated family history of cardiac problems) and it was 12.8 which apparantley is on the high side of normal. I have only just done some research on homocysteine today because of something someone mentioned over lunch today and I am wondering if 12.8 could be part of the reason why I miscarried. Do you ladies think I should get my levels checked again by my GP?

OH MY GOSH - i have had 2 MC this year - i didnt know that there was soooo many reason that could cause it all! now my hopes of carrying a bub to full term has been put aside! i think i may be in for a loooong wait to becoming a mum!

This question may be too in depth for a forum, but you ladies are so informed that here goes:

Does it make a difference if you have had healthy pregnancies before your problems started?

I had a healthy son and a healthy daughter. Then miscarried. Then another healthy daughter. Then three miscarriages.

I guess what I'm asking is, wouldn't some of these conditions show up early in your reproductive life? Or in other words, would I be able to skip some of these tests since I do have healthy children already?

Thanks for posting this information!

I have had 4 losses this year. One at 6.5 weeks, 2 chemicals at just over 4 weeks, and the last one at 5 weeks.

When I went to my ob/gyn here in Canberra after the 3rd loss, he was very positive and said there was a good chance it was bad luck as I am 39 and some of my eggs may not be of great quality. He had me tested for lupus syndrome, progesterone (at day 21) and some other things, and my husband and I also had our chromosomes tested. Everything came back normal. And then a month or so after that last appointment, I miscarried again (whole overseas) at 5 weeks.

I have another appointment on 17 December and I feel that I will have to be firm and assertive about getting more tests done. At this point, we may give up ttc no matter what the outcome. I personally feel that I am getting older than I'd like to be with a newborn, but more importantly I don't think I can face more loss. I also worry about having a sticky baby and then discovering that it had massive problems when doing routine testing... I think it would completely break me. Also DH and I at first did not want any children, so we have always been slightly on the fence so now I am getting back on the fence again after all of these losses. It's been devastating.

Anyhow, I appreciate this post more than I can tell you!! I have copied all of the info into a document and I will bring it with me to my appointment.

Hi Jules,
Your story sounds very similar to mine. I have had several very early miscarriages. My husband and I had all of the tests for this including karyotyping and clotting disorders- all came back normal (which I was warned about). Although my progesterone blood levels have been normal, my FS wonders whether my levels locally are too low after implantation; hence the early losses. As a result she has started me on hormone support to help keep my progesterone levels up. Fingers crossed this helps. The next step would be IUI but I'm hoping we have some luck prior to that.

So this is something worth addressing with your doctor.
Good luck!

Skipping girl

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Hi Jules,
Your story sounds very similar to mine. I have had several very early miscarriages. My husband and I had all of the tests for this including karyotyping and clotting disorders- all came back normal (which I was warned about). Although my progesterone blood levels have been normal, my FS wonders whether my levels locally are too low after implantation; hence the early losses. As a result she has started me on hormone support to help keep my progesterone levels up. Fingers crossed this helps. The next step would be IUI but I'm hoping we have some luck prior to that.

So this is something worth addressing with your doctor.
Good luck!

Skipping girl

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Hi SG - it makes me so sad that there are so many who have gone through this. It's so unfair! I hope you have luck with this new approach. I am curious, if you have been able to get pregnant on your own, why would you go to IUI? I don't know much about IUI. I hope you have some luck regardless and are blessed with a sticky baby soon!!

Hey ladies, I've also had 3 early miscarriages and I am pregnant again and have got as far as 10 weeks 5 days so far. I'm 41. I spent hundreds of dollars on testing only to have the FS to say he wouldn't offer any further treatment until I had a lap (which I'm still waiting for on the public list after about 6 months). He said I would keep having early m/c's as he thought I had a fibroid (from a scan) which did not show up on my scan last month. Doctors don't always have the answers. I fell pregnant again 2 months after stopping taking Vitex and it looks like this one might be a sticky one. I was on Vitex with the last two and I have read that there could be a link to early m/c & the taking of Vitex. If you happen to be taking it I'd suggest to get off it. Good luck for the future.

Goodmorning Everyone - i have had 2 MC this year - all early!
im currently going through a whole heap of BT with a FS at the Mater to try and find out what is wrong!
they seem to think it may be low Progesterone Levels!
im hoping its nothing too bad! and that we will be 3rd time lucky!

Hi everyone,

I had a m/c yesterday and been bleeding with pain and cramp. My doctor told that I am normal with genetic problem but she will send me some blood test to confirm if everything ok. I did ICSI in Aug this year and had the fresh embryo transfer end of Sep, then I got m/c only 15 days later, with HCG 34 on the bleeding day. I did not use any support medical treatment except they gave me progesterone cream. In Nov I did thaw cycle and I was get pregnancy easy with HCG 335 at 18DPO, this time they did not give me any medical treatment at all. Then I had the first ultrasound yesterday but nothing inside my u/s, my dr supposed to see the sac and heart beat, she sent me to special ultrasound to make sure I am not ectopic preg, lucky I did not. I went home couple hours and started bleeding, today is second day and hope all gone in next few days. Please tell me why I am get preg easily but the embryo can not develop or I have problem with genetic or something else, most reason is chronosome abnormal, is it? One thing, my DH had 2 kids before and he had vasactomy then we decide to go through with ICSI. Is that problem come from me or just I am bad luck with percentage of miscarriage. The first time ICSI is hard to success as i know and that was a chemical preg (i knew the day they put in embryo but for nature preg, people can not know and most end up with m/c, about 70%). I was excited and happy when I know I am preg but it changed the whole picture and concerned me to have baby again. Would you please advise which test do I need? At this moment, I am not thinking the preg until next year, at least I will get my next normal cycle, this year may not lucky to me and I did a second time too hurry.

I am bad mood now, please show me what to do? Thanks

Hi ladies - Just wanted to let you know the results of my doc appt yesterday. They found a problem! I have low levels of lupus antibodies and my gyn thinks that is what is causing the m/c. He wants me to start taking 150mg aspirin daily and the moment I fall pregnant again, he wants me to start progesterone suppositories just in case. He said I've had a hard enough year and he wants to throw whatever he can at this. I will be 40 in Feb 2008 so we don't have time to waste.

I am happy to have a plan, hopeful I will have some luck and optimistic that we can at least try a few things to prevent another m/c.

Good luck to all of you in finding answers!

HI everyone,
I hope i can answer a few of these questions.

Jules - that is great that you found an answer! Good luck :)

Tempus - it is possible to have normal pregnancies and then experience problems. I don't know much else about this.

Meggsy - My lab report says 13 is top of the range for homocysteine. Mine was 12/13. Combined with MTHFR and other clotting disorders this can be a problem. A lot of docs don't deal with this or say it is in range and it doesn't matter. But it can be a problem. Yes you should get it re-tested. This may be a problem for you. Given that you have a family history of cardiac problems, you should certainly be tested for the thrombophilias - MTHFR, Factor V Leiden, Prothrombin etc etc. The good news is homocysteine can be treated - I took 5mg folate (Megafol - no script required) for a few months and my level is now halved. HTH.

I am sorry to hear of all these losses ladies. I hope this information helps.

Question - i have had 2 MC this year - is it at least a good sign that i am falling pregnant even tho i keep miscarrying? could it be that bad a problem that i may never have a healthy sticky preg?
My fs is getting me to go through a whole heap of blood tests - the first lot came back all good - just waiting for the chromosomes ones to come back - DH was fine! and once i reach my PEAK day i have to continue with more blood test every 2nd day for the rest of my cycle!
he is leading towards a progesterone issue so he wants to monitor that!
im hoping it was just bad luck twice!

hj - I had two early m/c's this year. I then started the testing and nothing was found in what I had done. Several hundred dollars later and whilst waiting for a D&C & lap before I headed off to IVF (as my FS said that was my only option at my age) I found myself pregnant again. This time I've made it to the 2nd trimester. Doctors don't always have the answers. You could just find nothing is wrong and that things will work out for themselves.