History: - What about her nutrition, any F/H/O of Koch’s? Explore family
tree for genetic diseases, Life style disease /habit of either partner.
Low cost initial tests if not done elsewhere:-Caution:
Not to Rpt Lab tests except possibly ICT, APL, and gene disorders. Koch’s:-Common
Tests”- In addition suggestions made by some forum members, may carry
out Complete haemogram, Thalassaemia screening, Viral screening, Metabolic
screen (HBA1C & PPBS) &
endocrine screen( TSH, PRL, Total testosterone) Thrombophilias Screening, AMH-an
indirect way of assessing quality of oocyte, both partner Karyotyping, APLA,
Tests for SLE ,Urine RE C/S, H semen analysis & Bacteriological screening
of semen Pap.
Uncommon Tests: - AMA, ANA. Hystero-Laparoscopy-Minimal endometriosis & septal
diseases of uterus.
Psycho-immunology in the treatment of RSA is an emerging subject. Support of the
family members & relatives/ friends .But in the days of consumers many
doctors are hesitant to assure the couple “All is well, Next time such
unfortunate event will not occur. I am with you. God is going to bless you this
time.”
Summary:-Above all, uterine malformations, endocrine disorders and
advanced age of any one partner are the usual causes of may read RCOG green
top guideline no. 17 (issued on April, 2011). In about 50% cases the etiology
remains unexplored. But in such situation, I do prescribe, albeit imperially a
course of antibiotics for pelvic . Infection like doxycycline &
Azithromycin.
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