The most common cause of first trimester miscarriage is a chromosome imbalance in the embryo. Miscarriages can be tested for this issue but many are not. An evaluation for causes for recurrent miscarriage involves testing the people who are conceiving but may not result in an answer since the answer often lies within the embryo. Testing is important because if an issue is discovered and treated, miscarriage risk can be decreased. These issues can be anatomical (septum or fibroid), hormonal (thyroid disease), immune (antiphospholipid syndrome), chronic disease, or genetic. We provide a thorough, evidence-based evaluation at PNWF.

The testing should be tailored to each individual couple and their history. In general, testing includes a uterine cavity evaluation and blood tests screening for ovarian reserve, hormonal imbalances, genetic issues (balanced translocation), and antiphopholipid syndrome (an immune issue associated with miscarriage), and a semen analysis.

The treatment options depend on the results of the evaluation. If a hormonal issue is discovered through testing, the treatment is medical. If a structural defect is discovered in the uterus, the treatment is surgical. For the 50% of patients have all test results come back as normal, the most common reason for their losses is aneuploidy – an imbalance of chromosomes within the embryo (a genetic issue that happens at the level of the egg and sperm by chance). In these cases, the options are trying again with the support of your team at PNWF or screening the embryos for a genetic defect before conceiving. Genetic screening of embryos (sometimes called preimplantation genetic screening or testing), requires in vitro fertilization (IVF). We offer this option at PNWF and a discussion about it’s benefits and drawbacks is an important part of your care with us.

Contact our helpful patient care coordinators to get started with your evaluation and treatment. The demand for appointments can be high at times, we’re here to help.