Egg

New Screening Service for Miscarriages or Unsuccessful IVF Treatment

February 22, 2013

Burton Fertility are pleased to announce the launch of a new dedicated service for women who have experienced repeated miscarriages or unsuccessful IVF treatment.  

Our aim is to uncover why some pregnancies fail or do not establish in the first place.  We feel the causes of both eventualities are related and have developed a series of tests to identify treatable causes or, in many cases, offer couples reassurance that there really are no underlying problems allowing them to move forward with more confidence.

What is involved?

Our 'comprehensive implantation screening service', or "CISS" for short, includes a personal consultation during which your records will be reviewed, a detailed 3D ultrasound scan of the womb conducted, a series of blood tests performed, and a sample of the lining of the womb (an endometrial biopsy) taken all precisely timed with your menstrual cycle.

  • Your notes and past experiences are arguably the most important part of the story and we will look through these to double check nothing has been missed and that there are no obvious causes that need treatment in their own right.
  • The 3D ultrasound scan is something we have developed over the last 10 years and are internationally renowned for. We use 3D to look at the shape of your womb, exclude any obvious abnormalities and assess the blood flow.
  • The blood tests look for a heightened immunity (autoimmune screen), thyroid disorders, sticky blood that has a greater tendency to clot (thrombophilia screen), and your own genetic make-up (a karyotype). The latter test is for both partners.
  • The sample of the lining of the womb (an endometrial biopsy) is an exciting new test which allows us to measure the numbers and proportions of cells within the womb that control and govern implantation and the early stages of pregnancy, the most important of which are the natural killer (NK) cells. These cells can be measured in your blood but it is the cells in the womb that are the key. We are doing this part of the work in partnership with Professors Siobhan Quenby and Jan Brosens from the University of Warwick who are one the World's leading teams in the field of research into miscarriage.

This list is not exhaustive and additional tests may be suggested and undertaken after consultation.

Who should consider these tests?

Typically we would not recommend these tests unless you have had two or more miscarriages or two unsuccessful IVF cycles. However any couple or woman worried about their fertility potential in this context might want to consider some or all of the tests outlined above to provide reassurance or, in some cases, identify why they are not getting pregnant after IVF or are suffering pregnancy loss.

What might the tests show and are there any effective treatments available?

More often than not all of the tests will be normal. This is a good thing and allows us to offer reassurance. It does not, of course, guarantee a successful outcome but does allow many couples to move forward more positively.

  • The 3D ultrasound scan may show abnormalities of the womb such as fibroids, polyps, and adenomyosis. It may also reveal an abnormally shaped womb. The scan may reveal cysts on your ovaries, a swollen Fallopian tube (hydrosalpinx), or endometriosis. It also allows us to make a definitive diagnosis of polycystic ovaries. All of these conditions are amenable to various medical and surgical treatments which may improve your natural fertility or reduce your chance of miscarriage.
  • If the blood tests reveal a heightened immunity then a short course of steroids may be offered whilst certain thyroid disorders benefit from treatment with thyroid hormones (thyroxine). If you are found to have one of the many conditions associated with 'sticky blood' then an injection to help thin the blood (clexane) may be suggested. Genetic problems are not actually treatable but counselling will help you make an informed choice of how to proceed and whether pre-implantation tests (PGD and PGS) are appropriate for you.
  • If the sample of the lining of the womb shows you have an elevated level of natural killer (NK) cells we will offer a course of steroids (prednisolone) to reduce their production. Interestingly recent studies have suggested that the biopsy itself may improve the chances of IVF treatment working so it may well be a therapeutic option as well as a diagnostic one!

These conditions and their associated treatments will be discussed in more detail with you at the consultation but it is important to be aware from the outset that little research has been done in this field and none of the tests are proven beyond doubt to be effective. This does not mean that they are not effective but that studies have not been conducted to show that they do or do not work. Until such studies are performed we can only work on speculation.

Can the tests be done at any time?

No.  Some of these tests are related to your menstrual cycle and must be timed accordingly.  We do this by measuring hormones in your urine to predict when you will ovulate (the LH surge). We provide the kits for this and they are very easy to use. We ask you to contact us once the surge has occurred so we can time your visit for the scan, blood tests and biopsy. This is roughly 7 to 9 days later so there is some degree of flexibility.   

Is there a cost?

Unfortunately most of these tests are not available on the NHS and have to be privately funded therefore. We have priced the tests as competitively as we can to ensure we cover our costs. We have also broken the costs down for couples who only want some of the tests and offer a package for those who want the full assessment.

Sounds interesting:  what should I do now?

If you would like to talk to us in more detail about these tests and our 'comprehensive implantation screening service' please contact Nurture Fertility. We can send you some more detailed information and the exact costs relevant to you or we can arrange to see you for an initial consultation.

Contact details

Telephone our reception on 01283 593098 or email info@burtonfertility.co.uk