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What is involved?
Our 'comprehensive implantation screening service', or "CISS" for short, includes a personal consultation during which your records will be reviewed, a detailed 3D ultrasound scan of the womb conducted, a series of blood tests performed, and a sample of the lining of the womb (an endometrial biopsy) taken all precisely timed with your menstrual cycle.
• Your notes and past experiences are arguably the most important part of the story and we will look through these to double check nothing has been missed and that there are no obvious causes that need treatment in their own right.
• The 3D ultrasound scan is something we have developed over the last 10 years and are internationally renowned for. We use 3D to look at the shape of your womb, exclude any obvious abnormalities and assess the blood flow.
• The blood tests look for a heightened immunity (autoimmune screen), thyroid disorders, sticky blood that has a greater tendency to clot (thrombophilia screen), and your own genetic make-up (a karyotype). The latter test is for both partners.
• The sample of the lining of the womb (an endometrial biopsy) is an exciting new test which allows us to measure the numbers and proportions of cells within the womb that control and govern implantation and the early stages of pregnancy, the most important of which are the natural killer (NK) cells. These cells can be measured in your blood but it is the cells in the womb that are the key. We are doing this part of the work in partnership with Professors Siobhan Quenby and Jan Brosens from the University of Warwick who are one the World's leading teams in the field of research into miscarriage.
This list is not exhaustive and additional tests may be suggested and undertaken after consultation.
Who should consider these tests?
Typically we would not recommend these tests unless you have had two or more miscarriages or two unsuccessful IVF cycles. However any couple or woman worried about their fertility potential in this context might want to consider some or all of the tests outlined above to provide reassurance or, in some cases, identify why they are not getting pregnant after IVF or are suffering pregnancy loss.
When I had my NK test done with Siobhan Quenby, the report included numbers of cells within the womb lining sample and there were lots of different types. Her reg said that problems with the womb lining make up can point to issues with implantation and thickening of the womb.
Jan Brosens is the guy that did my scratch a few weeks ago- lovely guy.