From the Guidelines
When a woman experiences frequent miscarriages, the most critical tests to evaluate reproductive organ health include transvaginal ultrasound, hysterosalpingogram (HSG), and hysteroscopy, as these tests can help identify structural abnormalities, hormonal imbalances, genetic factors, or immunological issues that might contribute to recurrent pregnancy loss, as supported by the most recent study 1.
Tests for Reproductive Organ Health
The following tests are typically performed to evaluate the health of a woman's reproductive organs when experiencing frequent miscarriages:
- Transvaginal ultrasound to examine the uterus, fallopian tubes, and ovaries
- Hysterosalpingogram (HSG) to reveal abnormalities in the uterine cavity and fallopian tubes using X-ray contrast
- Hysteroscopy, where a thin scope examines the uterine cavity directly
- Sonohysterography to detect polyps or fibroids using saline solution and ultrasound
- Blood tests to check hormone levels, including thyroid, prolactin, and progesterone, and screen for autoimmune disorders, blood clotting issues, and genetic abnormalities
- Endometrial biopsy to evaluate the uterine lining
- Karyotyping of both partners to identify chromosomal issues
Additional Tests
Additional tests may include:
- 3D ultrasound for more detailed imaging
- MRI for complex cases These tests help identify the underlying causes of recurrent pregnancy loss, allowing for targeted treatment approaches to improve future pregnancy outcomes, as noted in 1 and 1.
Importance of Recent Studies
The most recent study 1 highlights the importance of evaluating diminished ovarian reserve as a potential risk factor for miscarriage, emphasizing the need for comprehensive testing to identify all possible causes of recurrent pregnancy loss.
Limitations and Considerations
While the available evidence provides valuable insights, limitations such as the quality of available evidence, potential confounders, and the need for further investigation should be considered when interpreting the results, as discussed in 1.
From the Research
Tests for Evaluating Reproductive Organ Health in Women with Frequent Miscarriages
To evaluate the health of a woman's reproductive organs when experiencing frequent miscarriages, several tests can be performed. These tests include:
- Triiodothyronine, Thyroxine, Thyroid stimulating hormone, and prolactin tests to check for endocrinological disorders 2
- Chromosomal analysis to check for genetic abnormalities 2
- Haemoglobin A1C and blood sugar tests to check for diabetes 2
- Magnetic resonance imaging (MRI) and 3D-ultrasound to check for uterine abnormalities 2
- Auto-antibodies profile, including antiphospholipid antibodies, anticardiolipin antibodies, lupus anticoagulant, antinuclear antibodies, anti-thyroid antibodies, and β2 glycoprotein1 2
- Torch profile, including Toxoplasma gondii, rubella, cytomegalovirus, and herpes simplex virus 2
- Blood vitamin D3 levels to check for vitamin D deficiency 2
- Psychological factors evaluation to check for stress and anxiety 2
- Body mass index (BMI) calculation to check for obesity or underweight 2
- Thrombotic factors evaluation, including protein S and C deficiency, Prothrombin G20210A mutation, anti-thrombin III, Factor V Leiden, and Methylenetetrahydrofolate reductase mutation 2
- Uterosalpingography (hysteronsalpingography) to check for uterine and fallopian tube abnormalities 2
- Hysteroscopy to check for intrauterine abnormalities 2, 3
- Sonohysterography to check for uterine cavitary defects 3
Risk Factors for Miscarriage
Several risk factors can contribute to miscarriage, including:
- Genetic factors 4, 5
- Anatomical factors, such as uterine abnormalities 4, 5
- Immunological factors, such as autoimmune disorders 4, 5
- Hormonal factors, such as thyroid disorders 4, 5, 6
- Infections, such as Toxoplasma gondii, rubella, cytomegalovirus, and herpes simplex virus 4, 5
- Lifestyle factors, such as smoking, alcohol consumption, and stress 5
- Age, with women under 20 or over 35 years at higher risk 5
- Previous miscarriages, with women who have had multiple miscarriages at higher risk 5