OK, ladies. I'm posting this for 2 reasons. 1) I know there are several of you that have experience with this testing and may be able to either decipher some of it for me and/or have opinions on what's on it and what's missing, from your experience, and 2) Some of you who haven't had this experience might be curious about it.
I received my lab order today for all the testing the RE wants me to do in an effort to find the cause of my two early miscarriages. The weirdest part to me is that it includes an HSG (hysterosalpingogram), but I have a good one on file from a year and a half ago. Why they want another one is going on my list of questions to ask when I call them next week. (I can't take the tests for 6 weeks from the miscarriage, so I have time.)
Here are the others:
Blood Tests
CBC with differential (automated)
Comprehensive metabolic panel (aka Chem 20 panel)
Prolactin (fasting)
TSH
Antithrombin III Activity
Cardiolipin AB Wireflex to ID titer (aka Anticardiolipin Ab (IgG/IgM)
Factor II activity (prothrombin 20210A mutation)
Factor V (Leiden) Mutation
Fasting Homocysteine level, Plasma
Lupus Anticoagulant Evaluation
Phosphatidylserine antibodies (aka AntiPhosphoSerine Ab (IgG/IgM))
Plasminogen Activator Inhib (PAI-1)
Protein C-Activity
Protein S-Activity
Cervical Cultures
Routine aerobic (I am wondering what this is, because it's so vague-sounding)
Mycoplasma/Ureaplasma
That pretty much covers it. Please, share any thoughts. And thanks. =)
Resep Tahu Gimbal Semarang Yoi Enak
8 years ago
9 comments:
I do think your Dr. is being proactive in getting the HSG again, but could they possibly be wanting the SHG (saline ultrasound)? My RE has me set for the SHG, as he says it allows him to see the uterus more clearly and gage if there is scar tissue or any other abnormality following loss. Perhaps, your Dr. just wants to see for him/herself.
As for all the other tests, my Dr. ordered many of these yesterday and I gave 10 viles of blood today. I'm glad my Dr. is getting all he needs, as he wants to avoid another m/c'g if at all possible. The only tests we aren't getting are kerotype (sp) genetic tests, as we don't have any history of issues.
Best of Luck and I will be thinking of you.
Thanks, Andrea. They quite clearly marked hysterosalpingogram (HSG) on the form, so it appears to be what he intended. We did have the karyotyping done already, and that was normal.
10 vials?? Yikes! I hope they use the regular small-guage needles for it. I've had issues with the bigger ones they use for donating blood!
This book is helpful in understanding the immunology stuff: Is Your Body Baby-Friendly?: Unexplained Infertility, Miscarriage & IVF Failure - Explained and Treated by Alan Beer (amazon link: http://tinyurl.com/28mjoto) Dr. Beer was the guy who figured out all this reproductive immunology stuff.
I had the Factor II and Factor V testing done with the MHTFR testing to check for thrombophilia. Have you been checked for MTHFR? If not, i would expect that to be in the list. (They're all markers for thrombophilia = likelihood to clot = common cause for miscarriage.) (I have the MTHFR mutation, but not the others. Was on Heparin started from a few days before retrieval for this.)
I had all the immunology stuff run. My test result sheet describes an NK Assay Panel (NK = natural killer cells). That has the IgG stuff. Another test sheet lists the TH1:TH2 ratios (mine were elevated, and we treated those with two Intralipid infusions via IV after I found out I was pregnant.) I also have a sheet listing anti-phospholipid antibodies (various IgM, IgG and IgA names, all of which were negative for me.) Some of the tests you listed are on the sheet (Cardiolipin and phosphoserine.)
Also had CBCs done a whole bunch of times (they use them to monitor you while you're on Heparin). Had TSH levels checked, and prolactin.
The immunology blood draw was 6 or 7 vials for me, and I've done the full workup twice. I did just the TH1/TH2 levels another time.
Hope that helps!
I wanted to chime in about the MTHFR. That could be part of another test, even though you may not realize it. Plus, it's actually common for people to have it (well, the hetero version) and if your homocystine (spelling) levels are fine, then your body shouldn't have an issue with taking in folic acid.
One thing that I didn't have tested that I'm going to ask about is a endometrial biopsy. If there's a problem with the lining, there can be a problem with implantation and since your losses are early losses (like mine)...
Good luck! I've also been told that drinking lots of water helps before having so much blood drawn.
Wow, thanks for all the info ladies! I'll be checking for all the stuff you mentioned and make sure I have my questions ready for the RE!
I think the fasting homocysteine level is what they are testing regarding MTHFR, because (from what I understand) that's the effect of MTHFR that actually ends up causing the m/c problems-but it's definitely a question going on my list to ask them about.
And thanks for the book suggestion, Crystal!
You guys rock!
I'm glad your doc is doing it work up now, without waiting for more miscarriages. My doc waited until my 4th miscarriage to do the work-up. All my results were normalish, nothing so out of wack to explain the miscarriages... but I was still glad he did all the tests, especially the genetics one (though it was expensive!).
Good luck!
Yes, they used the small gauge needle :) I must have looked at the tray after the 3rd tube with a strange look, as the lab tech said "you've got lots more to go". Yep, 10 viles.
I know it stinks to repeat a test, like the HSG, but at least your Dr. will have the most current result on hand. Just praying these are the last tests that you have to endure.
Hang in there and I'll be thinkin' of you :)
Hi there, just came across your blog via a google search. In the UK I had something called a thromboelastogram (thromboelastography) after my 3rd loss which checks how fast blood clots. It showed I had a non specified clotting problem which required aspirin 150mg daily. According to research this works in 75% of cases. I was obviouly in the wrong 25%. Two more m/c later and I was on clexane and now have a little boy. In the UK not so many doctors test for this for RMC, but it's a relatively simple procedure used in surgery. Might be worth asking... Good luck with the tests, I wasn't fussed by the needle aspect, providing I didn't look!
When I started the IVF process I did 13 viles in one day. Not fun. I only had 6 when I started this round and I felt lucky. How sad is that.
Post a Comment