What Tests May Be Recommended?
Your evaluation will be personalized based on your medical history, previous pregnancies, ultrasound findings, and other relevant factors. Depending on your situation, I may recommend some of the following:
Parental Chromosome Testing (Karyotype)
In a small percentage of couples with recurrent pregnancy loss, one or both partners may carry a structural chromosome abnormality. A karyotype is a blood test that examines your chromosomes and may help identify whether a genetic factor could be contributing to your pregnancy losses.
If an abnormality is identified, I will discuss what it may mean for your future pregnancies and, when appropriate, coordinate genetic counseling or referral for assisted reproductive options such as in vitro fertilization (IVF) with preimplantation genetic testing (PGT).
Uterine or Anatomical Abnormalities
Sometimes, the shape or condition of the uterus can affect implantation and the ability of a pregnancy to continue normally. Conditions such as a uterine septum, intrauterine scar tissue, endometrial polyps, or certain fibroids may be associated with recurrent pregnancy loss.
I can evaluate your uterus using specialized ultrasound techniques, including a saline infusion sonogram, when appropriate. In selected cases, hysteroscopy may be recommended to directly examine the inside of the uterus. Some abnormalities can also be treated through minimally invasive hysteroscopic surgery.
Antiphospholipid Syndrome and Other Immune-Related Factors
One important and treatable cause of recurrent pregnancy loss is antiphospholipid syndrome (APAS), an autoimmune condition in which certain antibodies increase the risk of abnormal blood clotting and pregnancy complications.
I may recommend specific blood tests to determine whether APAS could be contributing to your pregnancy losses. If you meet the diagnostic criteria, treatment during pregnancy, often involving medications that reduce clotting risk, may significantly improve pregnancy outcomes.
Hormonal and Metabolic Conditions
Certain hormonal and metabolic conditions can also increase your risk of miscarriage. These include poorly controlled diabetes and thyroid disorders.
As part of your evaluation, I will assess whether these or other relevant medical conditions need to be investigated or optimized. When an abnormality is identified, managing it before and during pregnancy can help create a healthier environment for your next pregnancy.