Recurrent Miscarriage: 5 Critical Tests Every Couple Must Get

Which tests reveal genetic and immune causes of miscarriage?

Quite often the answer sits in chromosomes or immune behaviour, and ignoring either side wastes cycles.

• Karyotyping. Both partners give a blood sample, and the lab looks for balanced translocations or rearrangements that affect about 3 to 5 percent of couples with repeat losses, and yes, even a carrier parent who’s perfectly healthy can pass on an embryo that won’t survive the first trimester.
• APLA panel. Lupus anticoagulant, anticardiolipin, and anti-beta-2 glycoprotein, that’s the trio, and two positive results twelve weeks apart confirm antiphospholipid syndrome which happens to be one of the more responsive causes once treatment starts.
• ANA screening. Antinuclear antibodies hint at autoimmune activity quietly interfering with how the placenta settles in, and standard fertility panels skip this far too often.
• NK cells. Uterine natural killer cell activity gets blamed a lot, sometimes fairly, sometimes not, and reproductive immunologists still argue about when testing actually changes outcomes.

Even one positive result rewrites the next protocol, which is why karyotyping deserves a spot at the top of any IVF treatment plan after a second loss.

What hormonal and uterine factors need to be ruled out?

Hormones and uterine shape carry a surprising share of the blame, and these are usually fixable.

• Thyroid profile. TSH sitting above 2.5 mIU/L with positive TPO antibodies is a quiet driver of first-trimester loss, and a small dose of levothyroxine sorts most of these cases out without drama.
• Prolactin and PCOS. High prolactin chips away at the luteal phase, while unmanaged insulin resistance in PCOS leaves the endometrium poorly prepared for implantation, both common, both treatable.
• Uterine imaging. A 3D ultrasound or saline infusion sonography picks up septate uteri, adhesions, and submucous fibroids that distort the cavity, and hysteroscopy then confirms and corrects whatever was found.
• Thrombophilia. Factor V Leiden, prothrombin gene mutation, protein C and S, antithrombin III, these clotting factors quietly compromise placental flow and need targeted screening, not assumptions.

Looking at one report on its own rarely tells the full story, so combined interpretation matters, much like during a Recurrent Miscarriage discussion where multiple markers feed into a single decision.

Why Choose Dr. Manisha Mehta for Recurrent Miscarriage Solution ?

Dr. Manisha Mehta has spent over two decades in reproductive medicine, with an MBBS from MAMC New Delhi, an MD in Obstetrics and Gynaecology from Lady Hardinge Medical College, plus DNB credentials, and active memberships at ASRM and ESHRE. Her IVF programme reports an 85% success rate, and the recurrent miscarriage workup gets done in full during the first consultation, not stretched across months of repeat visits.

A large share of her caseload involves couples already two or three losses in, often carrying antiphospholipid syndrome, a septate uterus, or the frustrating label of unexplained recurrent loss. Every protocol gets built around confirmed test findings, not guesswork, and she’s honest about the numbers rather than offering empty reassurance.

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