Fertility Study Infertility: repeated abortions

If a couple experiences 2 or more spontaneous abortions, we should perform a complete infertility analysis of the man and woman.

An abortion is defined as an end to the pregnancy before 22 weeks of pregnancy. The general rate of abortion is between 10-15% and increases with the age of the mother. In our fertility clinic, we start the infertility study after two spontaneous abortions.

Close to 60% of abortions (particularly those during the 1st trimester) originate from a genetic alteration. There is no unique protocol for this type of study, because it can be adapted to the case of each patient.

The preliminary tests are as follows:

  • General analysis: blood count, coagulation, renal and hepatic function
  • Hormonal block
  • Specific analysis of antibodies (to solve possible auto-immunity problems) and the study of Homeostasis (blood)
  • Analysis of infections (toxoplasmosis, Rubella, etc.)
  • Karyotope on peripheral blood in both partner.
  • Gynecological test
  • Transvaginal ultrasound with Color Doppler (and 4D)
  • Sonohysterography
  • Hysterosalpingogram
  • Sperm analysis – REM-TM Test – Sperm magnification test

Other tests to perform as per the recommendation of the doctor:

  • FISH on sperms
  • DNA Fragmentation
  • Meiosis study of testicular biopsy
  • Embryo genetic diagnostic (DGP): during in vitro fertilization
Last Update: 06/09/2014
References:
– Bellver L, Serra V, Reis S. Aborto de repetición: diagnóstico y planteamiento de reproducción. En: Manual Práctico de Esterilidad y Reproducción Humana. McGraw-Hill Interamericana 2005. 46-66.
– Blumenfeld Z, Brenner B. Thrombophilia associaed pregnancy wastage. Fertil Steril 1999; 72: 765- 74.
– Matorras R, Hernández J (eds): Estudio y tratamiento de la pareja estéril: Recomendaciones de la Sociedad Española de Fertilidad, con la colaboración de la Asociación Española para el Estudio de la Biología de la Reproducción, de la Asociación Española de Andrología y de la Sociedad Española de Contracepción. Adalia, Madrid 2007.