A fairly well known but often unexplored avenue for recurrent pregnancy loss is immune system and inflammation issues. There are thousands of articles and stacks of research on the connection, but few clinics, especially clinics in Canada, explore these issues. Rather, they run the standard RPL panel, which focuses more on issues that cause second trimester losses (such as clotting issues).
According to Reproductive Immunology Associates (http://www.rialab.com/miscarriages_prevented.php), up to 50% of repeat early losses are caused by immune factors, either autoimmune (female's body fighting itself) or alloimmune (immune response to the father's cells in the embryo). Unfortunately, many of the tests recommended for detecting these issues are not performed regularly in Canada, so we pay out of pocket to send it to the U.S.
In a cost saving effort, I went to my GP and asked her to order as many tests as possible locally. Luckily, she is very understanding and accommodating, and ordered exactly what I asked for, plus a few other factors such as Vitamin D (summary of it's use in miscarriage here) and iron, as well as a full thrombophilia panel (clotting issues). Everything came back within normal parameters, though my Vitamin D was low for TTC. Odd how I'm disappointed that everything is normal - I suppose I was hoping for an answer.
Next on the list of important tests is an NK Cell Assay. Dr. Beer describes Natural Killer cells: "The bulk of the cells detected that express CD56 on their surface have a particular function that accounts for their name, natural killer cell. This function is, of course, the ability to identify and then kill foreign or abnormal cells. Identification of the number and activity of these cells gives us an idea of the strength of this killing capacity." Basically, these cells kill foreign materials. If the body sees a pregnancy as 'foreign' and 'abnormal', it will attack the embryo and cause a miscarriage. Assessing the levels of these NK cells in the body can give a better indication of the likelihood that an overactive immune system is the cause of early pregnancy loss.
I'm checking with both Reprosource and Millenova for costs, but word is that we're looking at between $250 and $400 for this test, not including shipping in to the U.S. I would love to do this before I leave for University in (eek!) a week and a half but it's unlikely. We'll aim for the end of October and hope for a short turn around in time for our FET in November/December. Fingers crossed for a sticky pregnancy by year end!
