Private Recurrent Miscarriage Tests in London

If you have had two or more miscarriages, whether or not they happened one after another, this package can give you an insight into possible causes and, where a treatable cause is found, offer advice and treatments to reduce the risk of another miscarriage and improve the chance of a successful pregnancy.

• Bloods Profile – to be completed prior to booked scan and consultation so that they can be reviewed in the consultation (please contact us at least a week before booking the appointment to arrange the blood tests on info@londonpregnancy.com)
• Scan and Consultation – to be booked between D5 – D12 of the menstrual cycle

In the mother, possible causes include the shape of the womb, antiphospholipid syndrome (APS) and thyroid or other hormone conditions. As such, it is important to conduct a thorough investigation of each of those factors at our recurrent miscarriage clinic in London. This includes a consultation and an expert pelvic ultrasound examination by our consultant gynaecologist, as well as a blood panel (takes 10-15 days) to screen for the following:

We can also arrange the following genetic tests (including genetic counselling):

• Karyotype Chromosome Analysis – £290 or £550 for a couple.

Within the panel, the lupus anticoagulant and cardiolipin antibody tests look for antiphospholipid syndrome, the thyroid profile checks how your thyroid is working, and the scan looks at the shape of your womb. These cover several of the core investigations in UK guidance; chromosome testing of pregnancy tissue, another key step, is explained further down this page. If an antiphospholipid test is positive, it needs repeating at least 12 weeks later to confirm the diagnosis.

The panel also includes tests for inherited clotting conditions, such as antithrombin, Factor V Leiden, prothrombin, protein C, protein S and MTHFR. The RCOG does not recommend these routinely after early miscarriages, because there is no clear evidence that they cause recurrent miscarriage. Our consultant will explain what any result means for you, which may be more about your own risk of blood clots in pregnancy than about miscarriage.

Karyotyping and carrier screening are optional. UK guidance reserves parental chromosome checks mainly for couples whose miscarriage tissue showed an unbalanced rearrangement or could not be tested, so we will talk through whether it is likely to help you first. Carrier screening looks for inherited conditions that could affect a future child; it is not one of the recommended investigations for the cause of miscarriage.

You will receive your ultrasound scan report shortly after your appointment via our secure cloud system. The bloods are processed by our partner laboratory TDL here in London and can take 10-15 days to be processed.

We are also happy to send the results to your GP and arrange any further referrals as appropriate.

In some cases, we may recommend tests for your partner, such as a chromosome blood test, and/or a more in-depth examination of the uterus, such as a saline scan or hysteroscopy, which we will be happy to arrange at an additional cost.

Where the womb lining itself is the question, a biopsy can also be tested for chronic endometritis — a silent, low-grade inflammation linked to recurrent pregnancy loss and treatable with antibiotics — using the ALICE test. This test is not part of the routine investigations in UK guidance, and whether treatment improves the chance of a baby is still uncertain.

After a loss, testing the chromosomes of the pregnancy tissue — products of conception genetic testing — can help explain why the miscarriage happened. In a future pregnancy, if you have early bleeding after a previous miscarriage, you may be offered progesterone treatment.

In the UK, the Royal College of Obstetricians and Gynaecologists (RCOG) uses the term recurrent miscarriage for three or more losses in the first trimester, roughly the first 12 weeks. Since its 2023 guideline, the losses no longer have to be one after another or with the same partner, so a healthy pregnancy in between does not reset the count.

You do not always have to wait for a third loss. Doctors may start tests after two early miscarriages if they suspect an underlying cause, and some hospitals are able to investigate after two. After a single miscarriage in the second trimester (a late miscarriage), tests should be offered straight away.

European guidance (ESHRE, 2022) sets the bar lower, at two pregnancy losses or more, and leaves out ectopic and molar pregnancies. Some clinics work to that definition, which is why our package is open to anyone who has had two or more miscarriages.

Recurrent miscarriage is far less common than a single loss. Roughly 1 woman in 100 has three or more miscarriages, and around 2 in 100 have had exactly two. If it has happened to you, you are not alone, and most people in this situation go on to have a baby.

In England, your GP will usually refer you to a doctor who specialises in miscarriage after three early miscarriages or one late miscarriage; in Scotland, care can start earlier. Some NHS hospitals investigate after two losses, and practice varies from area to area, so it is worth asking your GP what is available locally.

On the NHS, genetic testing of pregnancy tissue is usually requested from the third miscarriage onwards. In England, the national genomic test directory pairs a test for the commonest chromosome changes with a chromosomal microarray, which scans all the chromosomes for missing or extra material.

NICE also says early pregnancy units should accept self-referrals from women who have had recurrent miscarriage, so if pain or bleeding starts in a later pregnancy you can normally get in touch with them yourself, without going through your GP.

Private tests do not replace this pathway. People come to us to be seen sooner, after two losses, or alongside their NHS care, and we can share results with your GP or hospital team.

The outlook is better than many people expect. When no cause is found, UK guidance puts the chance of a successful future pregnancy with supportive care alone at around 75 in 100, and Tommy's quotes the same figure for couples cared for in a specialist clinic. Estimates vary between studies, and some are nearer 2 in 3.

Age and the number of previous losses make the biggest difference. A Danish study that followed women with recurrent miscarriage for five years found a live birth in roughly 8 out of 10 of those aged 20 to 24, but only around 4 out of 10 of those aged 40 or over. By history, roughly 7 out of 10 women with three losses had a baby in that time, falling to about half of those with six or more.

Recurrent miscarriage is also linked with a slightly higher chance of some later complications, such as premature birth or a baby not growing as expected, so extra monitoring may be offered next time. Our guide to preparing for your next pregnancy covers what to plan before trying again.

Recurrent miscarriage can be exhausting and lonely, and the emotional impact matters just as much as the medical investigations. Support is available whenever you need it.

Tommy's funds UK miscarriage research, including its National Centre for Miscarriage Research, and runs a free line staffed by midwives, open 9am to 5pm on weekdays (0800 0147 800). The Miscarriage Association, which now works under the name Miscarriage UK, has its own support line (0303 003 6464), online support and local groups for anyone affected by pregnancy loss.

Some recurrent miscarriage clinics offer bereavement counselling, and in England you can refer yourself to NHS talking therapies. You may also wish to apply for a baby loss certificate. Alongside these, our team is here to investigate the possible causes and support you through planning for another pregnancy.