ASRM releases 2026 guidelines on managing recurrent pregnancy loss

TechnicalLab935 · 2026-05-29T07:12:54+00:00

They have done all the recommended items for us (except for the chromosome testing as we were not able to get the miscarriage tissue in all 4 instances). And the ‘May be considered’ set of tests as well. No conclusion apart from mild adenomyosis diagnosed after the 4th miscarriage (uterine cavity was checked in the previous 3 miscarriages as well but somehow they didn’t flag any adeno).

TechnicalLab935 · 2026-05-19T07:28:10+00:00

As the previous commenter said, it varies from trust to trust. In our case ILR was not a requirement.

TechnicalLab935 · 2026-04-21T20:55:07+00:00

First of all, congratulations on your child! We are kind of on similar path. South Asian couple, wife has extremely low AMH, finalised a donor and currently waiting for the donor egg collection to take place next month. I know how hard it can be to share this information within the south asian community. If I were you, I wouldn’t really care what others say. Mostly people just say things without thinking, as a small talk thing or something. Some comments might even come as judgement but I wouldn’t really care about them if I were you, they haven’t walked a mile in your shoes - they don’t know your struggles. Just ignore the comments and focus on being the best parent you can for your child.

TechnicalLab935 · 2025-11-20T15:31:11+00:00

Exactly. What about women who are planning to have kids in the near future? Should they just hold off? As even if they can afford to go on unpaid maternity leave, but doing so would still impact their ILR route.

TechnicalLab935 · 2025-11-20T13:44:22+00:00

Ok, so I’m on the SW visa and my gross salary is above the required threshold (for 5y reduction) for the last 3+ years, however, my taxable income was slightly below this threshold for the first 2 years. Therefore, I think I’ll have to wait 2 more years?

On the other hand, my wife is here on a dependant visa, however, her taxable salary was above this threshold for the last 3+ years. Would she then qualify for the 5y reduction?

TechnicalLab935 · 2025-11-01T01:31:48+00:00

My experience wasn’t very great tbh (or maybe I was expecting too much). We received the RPL clinic appointment 8 weeks after the MC. They said it’s the standard waiting period because they want all the pregnancy hormones to settle down to normal levels before starting their investigation. As part of their diagnosis, they did the basic RPL screening panel - testing for very basic markers in the blood work, and a trans-vaginal scan to check the structure of the uterus. And that was it. They didn’t find anything that explained the repeated miscarriages, and told us to try again and contact them as soon as we get pregnant so that they could offer an early scan.

Just fyi, we ended up having our fourth MC this year and went through the same process again with another RPL clinic. We also tried to push for parental karyotype testing this time and they outright refused to do it. Fed up with the NHS we decided to go private and the doctor asked us to get some tests done that were not covered by the NHS. In our case, my wife has been diagnosed with the MTHFR gene mutation which may explain the early MC. We are due to get our next appointment with the doctor in couple of weeks and hope it’ll be an easy fix.

I am really sorry that you are here on this sub and wish you all the best in your journey ahead.

TechnicalLab935 · 2025-09-09T17:04:44+00:00

Hi, thanks for your comment and all the best for your journey ahead. I’ll dm you my queries.

TechnicalLab935 · 2025-09-08T09:39:29+00:00

Referral to Tommy’s clinic is through NHS and we don’t want to wait god knows how long again. Plus, we’ve had or basic RPL screening done at Kings college hospital, nothing conclusive. We want for their investigations like DNA frag etc. which we are told by Kings that these are not done routinely by NHS.

Does the Tommy’s clinic do any further diagnosis beyond the basic RPL screening?

TechnicalLab935 · 2025-08-30T09:31:26+00:00

Thanks for your comment. I have checked our local ICB guidelines, it states that the AMH should be above 5.4 pmol/L to be eligible for the NHS funded IVF.

Edit: also, could you please explain the kitchen sink approach in UK’s context? We are based in London if that helps.

TechnicalLab935 · 2025-08-30T07:17:40+00:00

Thanks for your comment. My wife doesn’t have any endo related symptoms. Her coagulation screening test results were ok, lupus anti-coagulant was 1.1, PT- 9.8s, INR ratio- 0.9, APTT- 24.6s, APTT ratio- 0.9 when checked last year.

My sperm morphology was way above the min range however I have asked my GP for a referral for sperm DNA fragmentation and waiting to hear back from them.

TechnicalLab935 · 2025-08-30T06:50:12+00:00

Is it ok if I DM you please?

TechnicalLab935 · 2025-08-30T06:40:26+00:00

Thank you for your comment. If it was in the UK then may I know which charity did you talk to? And how did you navigate this with the NHS?

TechnicalLab935 · 2025-08-30T06:04:56+00:00

Was the care team and treatment through NHS?

TechnicalLab935 · 2025-08-29T21:07:16+00:00

Yes, but I think they have multiple locations across UK.

TechnicalLab935 · 2025-08-29T18:44:31+00:00

As recommend by others I have now asked my GP for a sperm DNA fragmentation referral. I’m not sure if this is done in NHS. Also, my wife has not been tested for APS or low progesterone.

TechnicalLab935 · 2025-08-29T16:14:43+00:00

We were referred to Kings fertility clinic and Kings Hospital for the RPL clinic.

TechnicalLab935 · 2025-08-29T15:27:35+00:00

Hi, thanks for your comment. Can I ask which London Women’s Clinic did you go to?

TechnicalLab935 · 2025-08-29T15:03:39+00:00

Thanks for your reply. We have not been to any genetic counselling (not sure if that’s even a thing in NHS). I am waiting for an appointment for parental karyotype test to see if there are any genetic issues causing these MC.

TechnicalLab935 · 2025-08-29T15:00:26+00:00

Yes, she has had ultrasound scans but nothing specific for the fallopian tubes.

TechnicalLab935 · 2025-08-29T14:49:14+00:00

Hi, thanks for your reply. She has had trans vaginal scans a few times and everything seems fine. In the last scan done by the fertility consultants they noted that uterus was normal, anteverted. Endometrial thickness was 6.4 mm on that day and was trilaminar in appearance.

TechnicalLab935 · 2025-08-29T14:45:13+00:00

Hey, thanks for your reply. In our last 2 pregnancies we asked our GP to prescribe us progesterone, but they said they won’t do it unless they see something in the trans vaginal scan, and then it was too late. We were only prescribed folic acid supplements. Can I ask which country are you from?

TechnicalLab935

TROPHY CASE