Hi Dr Jessup, Thank you for assisting me with this question.
I have fallen pregnant naturally 3 times since 2007, 1st with my healthy daughter and then m/c at 15 weeks and then at 5 weeks. It has now been 12 months of TTC since then.
We had an autopsy done on 15 wk m/c which showed fine but no chromosome test was done (and I dont know why). A m/c this late concerns me.
We have had 3 natural IUIs and an IVF this year all resulting in negative. We got 10 blasts and our first natural FET is in a few weeks. A Laparoscopy showed clear in Nov 09.
As FS's like to see several m/cs before testing, I would like to be proactive in this area and get necessary autoimmune and neccessary testing now before money and time slips through our fingers. I would like to cover recurrent m/c and implantation failures.
I asked FS if I could have some tests and he gave me the following: Lupus Anticoaglent, ANF (what is this?), thrombophilia and one other. I really want to be thorough so do you think I should ask for the following tests to cover all areas?
Which ones should my husband be tested in?
- AntiNuclear Antibodies
PAI-1 levels and activity
Prothrombin II mutation
Protein C activity
Protein S activity
Factor V Leiden
Serum Immunoglobulins (IgG, IgM and IgA)
Thyroid levels (TSH, T3, T4)
MTHRR Gene Mutation
Urea Plasma DNA
TNF-a (TH1/TH2 Cytokines)
My FS gave me a blood test for NK Cells, but I see a biopsy on day 26-28 is the normal process. Can you please advise?
Cannot thank you enough for your help with this.
Results 1 to 3 of 3
16-08-2010 21:02 #1
19-08-2010 21:27 #2Appointed Bub Hub Online Expert
- Join Date
- Apr 2010
The list of tests you have outlined is certainly the comprehensive list of tests for RMC. Given that you have had two miscarriages, one at a relatively late gestation, and both at a relatively young maternal age, I do not think it would be unreasonable to investigate fully. My thoughts are that karyotyping for you and your husband is worthwhile, as well as a full thrombophilia screen, TSH, Antiphospholipid antibodies, ANA and LA. If you are Sydney based, a blood test looking at your NK cells is just as good as a mid-late luteal endometrial biopsy. The other tests you have indicated are slightly less commonly checked, but certainly would complete the workup. I assume your laparoscopy and ultrasound scans have excluded any uterine abnormalities.
Even after two miscarriages, the most likely outcome in your next pregnancy will be a healthy baby. You may wish to consider trying Prednsolone 20mg daily in your next cycle. This is what would be suggested if your NK cells were elevated. Keep trying . It sounds as though you have a good grasp of the issues, and I am sure given you have already had a baby, that is is just a matter of time before it all works for you again. Good luck. Sonya
20-08-2010 00:40 #3
Thanks Sonja. That is wonderful feedback. May I ask 2 more questions?
1. I am Perth based. Can a blood test be done here / sent to Sydney? Or would I have to have a biopsy?
2. What tests would be needed for a full thombophilia screen?
Many many thanks again.
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