A question for RPL ladies...

wendydances

Hi ladies! First and foremost I am so sorry for your losses and what you have gone through. 

I have had 2 mc and battled infertility for over 2 and a half years. I am having uterine septum removal surgery in September (just fund this a couple days ago) but am also going to get an RPL blood panel done.  I am looking at my lab slip and want to make sure all my bases are covered.

My question is, if any of you had an RPL blood panel done, do you remember all the different blood tests they ran?  

 

 

 

Rachaeleigh

I agree with PP, check out that blog post. I don't remember at all what specific tests were run

behapy2day

I am in the process of getting RLP testing done. I actually made a post about it yesterday, https://community.thebump.com/cs/ks/forums/thread/67908263.aspx. I got some good info on what else to ask for.

Also, this is a list that a friend of mine just gave me... not sure if it will be helpful.

 

Pregnancy Loss Testing

 

Stage 1 ? Least Invasive (Blood Work)

?         FSH, LH, Estradiol tests on day 3 of cycle

?         Baseline Bloodwork ? HIV, RPR, Hepatitis B&C, Rubella, TSH, Prolactin

?         Thyroglobulin Antibody

?         Antiphospholipid Antibodies ? IgG, IgM, IgA

?         Lupus Anticoagulant

?         PTT

?         ANA

?         Protein C and S

?         Leiden Factor V

?         CA-125

?         17 OH Progesterone

 

Stage 2 ? When Stage 1 is ?Normal? Blood Work

?         Glucose Tolerance Test

?         Chromosome Testing for Male and Female

?         Prothrombin Gene Mutation

?         Cultures: myco/ureaplasma, chlamydia

?         Homocystine Level

?         MTHFR genotype

 

Stage 3 ? More Invasive ? When Stages 1 & 2 are ?normal?

?         Clomid Challenge ? ultrasound, medication, FSH testing

?         Sonohysterography - SHG

 

Stage 4 ? Most Invasive & Advanced Testing, Male Testing

?         Cystic Fibrosis Testing

?         Hysterosalpingogram ? HSG

?         Semen Analysis

?         Kruger?s Strict Morphology

?         Baseline Blood Tests

 

 

BzeetyD

behapy2day:

I am in the process of getting RLP testing done. I actually made a post about it yesterday, https://community.thebump.com/cs/ks/forums/thread/67908263.aspx. I got some good info on what else to ask for.

Also, this is a list that a friend of mine just gave me... not sure if it will be helpful.

 

Pregnancy Loss Testing

 

Stage 1 ? Least Invasive (Blood Work)

?         FSH, LH, Estradiol tests on day 3 of cycle

?         Baseline Bloodwork ? HIV, RPR, Hepatitis B&C, Rubella, TSH, Prolactin

?         Thyroglobulin Antibody

?         Antiphospholipid Antibodies ? IgG, IgM, IgA

?         Lupus Anticoagulant

?         PTT

?         ANA

?         Protein C and S

?         Leiden Factor V

?         CA-125

?         17 OH Progesterone

 

Stage 2 ? When Stage 1 is ?Normal? Blood Work

?         Glucose Tolerance Test

?         Chromosome Testing for Male and Female

?         Prothrombin Gene Mutation

?         Cultures: myco/ureaplasma, chlamydia

?         Homocystine Level

?         MTHFR genotype

 

Stage 3 ? More Invasive ? When Stages 1 & 2 are ?normal?

?         Clomid Challenge ? ultrasound, medication, FSH testing

?         Sonohysterography - SHG

 

Stage 4 ? Most Invasive & Advanced Testing, Male Testing

?         Cystic Fibrosis Testing

?         Hysterosalpingogram ? HSG

?         Semen Analysis

?         Kruger?s Strict Morphology

?         Baseline Blood Tests

 

 

I think this list is almost completely listed in opposite order and incorrectly labeled as to the invasiveness. 

I want to pipe up for any lurkers out there and say that if you're truly having issues TTC or TTCAL an HSG, baseline bloodwork, and Semen Analysis using Kruger's Strict Morphology should be done FIRST.

An HSG will tell you about uterine abnormalities and the Semen Analysis would tell you if you're dealing with any male factor issues. An HSG is not especially invasive, it does involve an x-ray and a spectulum but it is not uncommon, and it is usually not especially painful and does not require any hospital or recovery time. Baseline testing is bloodwork on CD3 and CD21, not a big deal and not invasive and again, should be done FIRST.

Clomid should not be taken, even for a test, without having these things done or you could be wasting your time. 

More invasive options include uterine laparoscopy and/or hysteroscopy.

The blood tests listed at the top are the equivalent of RPL testing, including some of the tests in the 2nd section as well.  These are not "normal" tests to be run and they usually require at least 2 losses to be done, unless you have a family history of loss.

Just want to be sure that people have the right order and understand what to expect when they go searching for answers.

RedPhoenix625

BzeetyD:

behapy2day:

I am in the process of getting RLP testing done. I actually made a post about it yesterday, https://community.thebump.com/cs/ks/forums/thread/67908263.aspx. I got some good info on what else to ask for.

Also, this is a list that a friend of mine just gave me... not sure if it will be helpful.

 

Pregnancy Loss Testing

 

Stage 1 ? Least Invasive (Blood Work)

?         FSH, LH, Estradiol tests on day 3 of cycle

?         Baseline Bloodwork ? HIV, RPR, Hepatitis B&C, Rubella, TSH, Prolactin

?         Thyroglobulin Antibody

?         Antiphospholipid Antibodies ? IgG, IgM, IgA

?         Lupus Anticoagulant

?         PTT

?         ANA

?         Protein C and S

?         Leiden Factor V

?         CA-125

?         17 OH Progesterone

 

Stage 2 ? When Stage 1 is ?Normal? Blood Work

?         Glucose Tolerance Test

?         Chromosome Testing for Male and Female

?         Prothrombin Gene Mutation

?         Cultures: myco/ureaplasma, chlamydia

?         Homocystine Level

?         MTHFR genotype

 

Stage 3 ? More Invasive ? When Stages 1 & 2 are ?normal?

?         Clomid Challenge ? ultrasound, medication, FSH testing

?         Sonohysterography - SHG

 

Stage 4 ? Most Invasive & Advanced Testing, Male Testing

?         Cystic Fibrosis Testing

?         Hysterosalpingogram ? HSG

?         Semen Analysis

?         Kruger?s Strict Morphology

?         Baseline Blood Tests

 

 

I think this list is almost completely listed in opposite order and incorrectly labeled as to the invasiveness. 

I want to pipe up for any lurkers out there and say that if you're truly having issues TTC or TTCAL an HSG, baseline bloodwork, and Semen Analysis using Kruger's Strict Morphology should be done FIRST.

An HSG will tell you about uterine abnormalities and the Semen Analysis would tell you if you're dealing with any male factor issues. An HSG is not especially invasive, it does involve an x-ray and a spectulum but it is not uncommon, and it is usually not especially painful and does not require any hospital or recovery time. Baseline testing is bloodwork on CD3 and CD21, not a big deal and not invasive and again, should be done FIRST.

Clomid should not be taken, even for a test, without having these things done or you could be wasting your time. 

More invasive options include uterine laparoscopy and/or hysteroscopy.

The blood tests listed at the top are the equivalent of RPL testing, including some of the tests in the 2nd section as well.  These are not "normal" tests to be run and they usually require at least 2 losses to be done, unless you have a family history of loss.

Just want to be sure that people have the right order and understand what to expect when they go searching for answers.

 

killian09

I want to further clarify:  the basic infertility workup and the RPL workup are different.  A semen analysis is not a first step in a RPL workup in the absence of infertility issues. (At least not in the papers I've read or according to the recommendation of my OB and MFM.  I go to a large, academic hospital that is ranked in the top 10 in the country for its ob/gyn practice, so I don't think they are crazy outliers. ) 

My RPL workup included:

blood clotting tests: PT, PTT, PTT/INR, Protein S, Protein C Activity, AT3 Activity, Act. Protein C Resistance

autoimmune: anticardiolipin antibodies IgM & IgG, lupus anticoagulant

thyroid: TSH

genetics: karyotype of me & DH 

imaging: SHG (I actually got an MRI but that was chosen to better image paraovarian cysts--otherwise it's not the most common test) 

 

behapy2day

RedPhoenix625:

BzeetyD:

behapy2day:

I am in the process of getting RLP testing done. I actually made a post about it yesterday, https://community.thebump.com/cs/ks/forums/thread/67908263.aspx. I got some good info on what else to ask for.

Also, this is a list that a friend of mine just gave me... not sure if it will be helpful.

 

Pregnancy Loss Testing

 

Stage 1 ? Least Invasive (Blood Work)

?         FSH, LH, Estradiol tests on day 3 of cycle

?         Baseline Bloodwork ? HIV, RPR, Hepatitis B&C, Rubella, TSH, Prolactin

?         Thyroglobulin Antibody

?         Antiphospholipid Antibodies ? IgG, IgM, IgA

?         Lupus Anticoagulant

?         PTT

?         ANA

?         Protein C and S

?         Leiden Factor V

?         CA-125

?         17 OH Progesterone

 

Stage 2 ? When Stage 1 is ?Normal? Blood Work

?         Glucose Tolerance Test

?         Chromosome Testing for Male and Female

?         Prothrombin Gene Mutation

?         Cultures: myco/ureaplasma, chlamydia

?         Homocystine Level

?         MTHFR genotype

 

Stage 3 ? More Invasive ? When Stages 1 & 2 are ?normal?

?         Clomid Challenge ? ultrasound, medication, FSH testing

?         Sonohysterography - SHG

 

Stage 4 ? Most Invasive & Advanced Testing, Male Testing

?         Cystic Fibrosis Testing

?         Hysterosalpingogram ? HSG

?         Semen Analysis

?         Kruger?s Strict Morphology

?         Baseline Blood Tests

 

 

I think this list is almost completely listed in opposite order and incorrectly labeled as to the invasiveness. 

I want to pipe up for any lurkers out there and say that if you're truly having issues TTC or TTCAL an HSG, baseline bloodwork, and Semen Analysis using Kruger's Strict Morphology should be done FIRST.

An HSG will tell you about uterine abnormalities and the Semen Analysis would tell you if you're dealing with any male factor issues. An HSG is not especially invasive, it does involve an x-ray and a spectulum but it is not uncommon, and it is usually not especially painful and does not require any hospital or recovery time. Baseline testing is bloodwork on CD3 and CD21, not a big deal and not invasive and again, should be done FIRST.

Clomid should not be taken, even for a test, without having these things done or you could be wasting your time. 

More invasive options include uterine laparoscopy and/or hysteroscopy.

The blood tests listed at the top are the equivalent of RPL testing, including some of the tests in the 2nd section as well.  These are not "normal" tests to be run and they usually require at least 2 losses to be done, unless you have a family history of loss.

Just want to be sure that people have the right order and understand what to expect when they go searching for answers.

 

I just got it in an email today from a friend who had gone through several losses. I'm still totally learning so I apologize for the misinformation. Would it be better to delete it as to not confuse or misinform anyone?

arishia

My OB ran every blood clotting, autoimmune, and thyroid problem, as well as progesterone. We're not having any trouble conceiving, just getting sticky babies. If you're having actual infertility issues, than I'd assume there would be other things to run. Good luck!

BzeetyD

killian09:

I want to further clarify:  the basic infertility workup and the RPL workup are different.  A semen analysis is not a first step in a RPL workup in the absence of infertility issues. (At least not in the papers I've read or according to the recommendation of my OB and MFM.  I go to a large, academic hospital that is ranked in the top 10 in the country for its ob/gyn practice, so I don't think they are crazy outliers. ) 

My RPL workup included:

blood clotting tests: PT, PTT, PTT/INR, Protein S, Protein C Activity, AT3 Activity, Act. Protein C Resistance

autoimmune: anticardiolipin antibodies IgM & IgG, lupus anticoagulant

thyroid: TSH

genetics: karyotype of me & DH 

imaging: SHG (I actually got an MRI but that was chosen to better image paraovarian cysts--otherwise it's not the most common test) 

 

Yes! 

wendydances

Thanks ladies!

We fall under both "lovely" categories (infertility and RPL) but did all the infertility testing in March 2011 before getting on clomid (HSG and bloodwork for me, semen analysis for DH).  Right after that testing we got PG on our first clomid cycle but lost it at 5 weeks , but couldnt conceive again, even with the clomid, so we did an IUI in March of this year and m/c again.  I decided to go to an RE (my regular OB did the IUI and testing up until this point) but I needed to go to an RE to get an RPL done.  He wanted to do more testing, but did an ultrasound and found I have a uterine septum that he said is most likely the cause of our infertility problems and our 2 m/c.  I had DH's "sperm report card" that was taken the day of our IUI in March of this year and I showed it to the RE this week, the day I went to see him.  He looked at it and said it looked extremely well. I am still going to have all the RPL blood testing done, another HSG as well as surgery to remove the uterine septum then we will do another IUI.  FUN!