Essential Tests for Recurrent Miscarriage: A Guide for Couples

What tests should be conducted for recurrent miscarriages?

Hello, I would like to ask about my wife.
She has had two pregnancies where the fetus did not have a heartbeat.
My wife has diabetes and is overweight, and we both have a family history of diabetes.
My wife has diabetes, but I do not.
We have consulted other clinics, and they suggested that we undergo genetic and chromosomal testing to identify the underlying issues.
I would like to know which department we should consult for these tests at the National Health Insurance Administration, and whether the costs will be very high.

yu, 30~39 year old female. Ask Date: 2009/10/07

Dr. Li Guanghan reply Obstetrics and Gynecology

Dear Sir/Madam,
Recurrent miscarriage is defined as having three consecutive pregnancy losses.
Both partners may consider undergoing blood tests for chromosomal analysis.
You can consult with the obstetrics and gynecology department at the hospital.
It is recommended that women with diabetes ensure their blood sugar levels are well controlled before planning a pregnancy and continue to manage them during pregnancy.
May God bless you.
Dr.
Li Guang-Han, Department of Obstetrics and Gynecology, Hsinchu Hospital, Department of Health, Executive Yuan.

Reply Date: 2009/10/07

More Info

I'm sorry to hear about the challenges you and your wife are facing with recurrent miscarriages. It's understandable that you want to seek answers and ensure the best possible outcomes for future pregnancies. Recurrent miscarriage, defined as having two or more consecutive pregnancy losses, can be a complex issue with various underlying causes.
Given your wife's history of miscarriages and her existing health conditions, such as diabetes and obesity, it is crucial to approach this situation with a comprehensive plan. Here are some essential tests and considerations for couples experiencing recurrent miscarriage:
1. Genetic Testing: Genetic abnormalities can play a significant role in miscarriages. Both parents may undergo karyotyping to check for chromosomal abnormalities. This test can identify structural issues in chromosomes that may lead to pregnancy loss.

2. Hormonal Assessments: Hormonal imbalances, particularly involving progesterone, can affect the ability to maintain a pregnancy. Testing hormone levels during the luteal phase (the time between ovulation and the start of menstruation) can provide insights into whether hormonal support is needed.

3. Thrombophilia Screening: Some women have blood clotting disorders that can increase the risk of miscarriage. Tests for conditions like antiphospholipid syndrome, Factor V Leiden mutation, and other thrombophilias can be beneficial.

4. Uterine Evaluation: Structural abnormalities in the uterus, such as fibroids, polyps, or congenital anomalies, can lead to miscarriages. A hysterosalpingogram (HSG) or a hysteroscopy may be recommended to evaluate the uterine cavity.

5. Diabetes Management: Since your wife has diabetes, it's essential to ensure that her blood sugar levels are well-controlled before and during pregnancy. Poorly managed diabetes can increase the risk of miscarriage and other complications.

6. Immunological Testing: In some cases, immune system issues may contribute to recurrent miscarriages. Tests for autoimmune conditions or antiphospholipid antibodies may be considered.

7. Lifestyle Factors: Addressing lifestyle factors such as weight management, nutrition, and stress reduction can also play a significant role in improving reproductive health. Consulting with a nutritionist or a specialist in reproductive endocrinology may be beneficial.

Regarding where to get these tests done, you should consider consulting a reproductive endocrinologist or a fertility specialist. These professionals are well-equipped to handle cases of recurrent miscarriage and can guide you through the necessary evaluations and treatments. If you are considering a specific facility like the one you mentioned (署新), it would be best to contact them directly to inquire about the specific tests available, the specialties they offer, and the associated costs.
Costs can vary widely depending on the tests performed and the healthcare facility. Some insurance plans may cover certain tests, especially if there is a documented history of recurrent miscarriage, so it would be wise to check with your insurance provider as well.

In conclusion, while recurrent miscarriage can be distressing, a thorough evaluation can help identify potential causes and guide you toward appropriate interventions. Working closely with healthcare professionals who specialize in this area will provide you with the best chance of a successful pregnancy in the future. Wishing you and your wife all the best on this journey.

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