Recurrent pregnancy loss evaluation

For some couples, achieving a pregnancy is relatively easy; having the pregnancy continue to the point of viability, on the other hand, is very difficult. Such patients have a condition called recurrent miscarriage (also known as recurrent abortion or recurrent pregnancy loss). A woman is diagnosed with recurrent miscarriage once she has had three or more consecutive clinical pregnancy losses without a live birth. In couples with this condition, a thorough evaluation will identify a definitive problem in approximately 60% of cases. In the other 40%, we may not be able to identify a specific cause.

 Diagnosis of recurrent pregnancy loss

The basic diagnostic testing for recurrent pregnancy loss includes:

• Evaluation of parental chromosomes (“karyotype”).  This test is performed by analyzing a blood sample obtained from each parent.
• Cervical cultures, which are performed on the woman to rule out the presence of an infection.
• Hysterosalpingogram (HSG), which is an X Ray in which dye is injected through the vagina into the uterus to evaluate the shape and contour of the uterine cavity.
• A blood test for lupus anticoagulant (aPTTT as well as a confirmatory test).
• A blood test for anticardiolipin antibodies.

Other tests, such as testing for insulin resistance, lupus, anti-thyroid antibodies, or endo-toxins have been determined by the American Society for Reproductive Medicine to be of no proven benefit.

Next: Treatment of Recurrent Miscarriage