Recurrent miscarriage - what tests should I be having to investigate?

Morning all,

Since my last miscarriage I have since been offered a battery of tests to investigate this both through the NHS and privately. It is suspected the last miscarriage was with a PGS normal embryo (although it was female tissue so there is a 50:50 chance it was my tissue). I had a MMC then my son and then a MMC.

I have listed below the tests I am currently in the process of getting. At 41, I don't have time to hang about, so could you please let me know if there is anything else I should be getting checked for?

Also, I've been referred to Dr Raj Rai at St Mary's in London for a number of these tests. Please can you message me if you have any experience of him / his team.

Many thanks!

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Bloods through GP:

Lupus anticoagulant;

Thyroid;

HBA 1C (diabetic);

Antinuclear (autoimmune disease);

Full blood count;

Liver/stroke anemia (for iron deficiency);

Blood clotting through St Mary's:

Thromboelastagram;

Thrombophilia screen;

Antiphospholipid antibodies

Chicago test:

NK cells;

Cytokines

[Lorita1984]

Have you done an Era test?

[Hidden in reply to Lorita1984]

I have had 3 natural FETs with blasts and got pregnant each time. So implantation doesn’t seem to be the issue, it’s staying pregnant.

First pregnancy ended when the embryo was 7.5 weeks, second pregnancy we got our son and the third ended when they were both 6.5 weeks.

All FETs were from 1 IVF cycle, so I put it down to genetic issues with the embryos (was 39 when did the cycle). With uncertainty over whether the last miscarriage was due to genetics is resulting in me looking into other causes.

If my understanding is correct, ERA is more for repeated implantation failure. Happy to consider further if this isn’t the case however.

[Fingerscrossed38 in reply to Hidden]

When I had my chemical of pgs normal blast although it technically implanted the Dr said it might have been transferred on the wrong window and an ERA would be helpful. So I did it. It came back with needing to delay transfer (basically by doing trigger in the morning 12 hours earlier than the evening last time) so the ERA did suggest something but I think because you've had mmc ERA pregnant not necessary?

Have you had a Hysteroscopy to check everything looks normal on your uterus? No tissue or polyps or fibroids?

Xx

[Hidden in reply to Fingerscrossed38]

Have had a few over the years and nothing to report. Not to say since having my son it’s not worth considering.

[Fingerscrossed38 in reply to Hidden]

Had my Hysteroscopy done at the same time as my ERA/Alice/Emma. Alice came back with low good bacteria so have been on probiotics. Have heard different theories on it though as with everything! Just wish all these tests weren't so painful and expensive😖

[Dogpark]

In addition to ERA, you can have several other tests done in the endometrial biopsy including ALICE and EMMA, as well as some immune/NK cells tests which are more reliable to be done via biopsy than via blood tests - hence I think this would be helpful for you.

[Hidden in reply to Dogpark]

Thanks yes, forgot about those! Have added to the list.