What tests are done for couples with Recurrent Pregnancy Loss-Dr.Suman Singh of Cloudnine Hospitals

All women with recurrent pregnancy loss should be tested for antiphospholipid antibodies. This is the most important treatable causes. We should not miss out these causes. Typically patients should have atleast 2 positive tests, atleast 12 weeks apart for lupus anticoagulant or anticardiolipin antibodies of either the IgG or IgM variety present and atleast medium to high titres of more than 40gms/L. Typically test recommended would be anticardiolipin antibody IgG, gM. Dilute Russel venom test and also platelet neutralisation procedure done with the dilute Russel venom test and the beta2 glycoprotein 1 both IgG and IgM. Also if the patient is having more than two pregnancy losses the karyotyping of the products of conception should be done. If the products of conception show a chromosomal defect, structural chromosomal defects then the parental chromosomal typing also should be done. For anatomical causes we have to do an ultrasound or 3D ultrasound to rule put septal defects, arcuate defects and intrauterine adhesions. Sometimes tests like HSG or laparoscopy or a hysteroscopy will be needed. Then test for inherited haemophilia like factor 5 linked mutations C proteinase deficiencies or prothrombin mutations should be recommended or advocated for patients with second trimester miscarriages. These tests should be done apart from the routine tests of a routine blood count like a complete blood count, blood sugars, a thyroid profile and a semen analysis for the male partner.

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Nice video about role of Chromosomal abnormalities in causing miscarriages.
I would like to add few more things here. Chromosomal abnormalities are responsible for about 50 % cases of recurrent miscarriages. Althouh with advancing maternal age the role of chromosomal abnormalities in casing miscarriages tend to decrease. In second trimester it causes miscarriages in about one third of the cases while in third trimester it is respinsbile for about 5 5 cases of miscarriages. Among all chromosomal abnormalities the Turner Syndrome is the most common single abnormality found in patints with recurrent miscarraiges.