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Of all pregnancies, 15-20% end in miscarriage; 75% of these in the first 12 weeks of pregnancy. Infertility is defined as 2 or more consecutive miscarriages. If you have experienced multiple miscarriages, you may need one or more of the following tests:
- Hormonal Factors Tests. Ask to have a prolactin, thyroid and progesterone level taken. If they are abnormal and treatment is given, make sure that you are re-tested to check your levels.
- Structural Factors Tests. A hysterosalpingogram is done to evaluate the shape and size of your uterus and to rule out possible scarring, polyps, fibroids or a septal wall, which could affect implantation. If there is concern about the uterine cavity, a hysteroscopy (examination done in combination with laparoscopy or as an office procedure) can be done. In some women the cervical muscle is too loose, causing pregnancy loss after the first trimester. A special exam is done when a woman is not pregnant to check for an incompetent cervix.
- Adequacy of the Uterine Lining Tests. An endometrial biopsy is done on cycle day 21 or later and will document if your lining is getting thick enough for the fertilized egg to implant. If you have a lag of two or more days in the development of the lining, you will be treated with various hormones (Clomiphene, hCG, Progesterone). It is important to have the biopsy repeated after several cycles to ensure the treatment is helping. If you are on Progesterone, discuss the advantages of the oral, vaginal gel creams or tablets or injection routes with your doctor.
- Tests for Chromosomal Causes. Chromosomal tests are rarely done on tissue from a miscarriage because it is difficult to preserve the tissue for adequate studies. If chromosome testing is needed, you and your partner will have blood tests to make sure there is no translocation of genes (a condition in which the number of genes is the normal 46, but they are joined together abnormally). This condition can result in pregnancy loss.
- Tests for Immunologic Causes. Blood tests to check for immunologic responses that can cause pregnancy loss include antithyroid antibodies (antibodies to thyroglobulin and thyroid peroxidase) the lupus anticoagulant factor and anticardiolipin antibodies. These appear to influence blood clotting mechanisms within the placenta as it develops. There are also blood tests that check for protective blocking factors. These are essential to protect the pregnancy from being rejected by the mother's body.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.