Thrombophilia Testing

[Cariad82]

Hi

I am doing some investigations after 3 failed IVF's. I am getting the Level 1 immune tests done largely through my GP, but the GP said they won't do the Thrombophilia (including Factor V Leiden and Panthrombin gene mutation) test.

I have looked at getting this privately and the cost ranges from £250 - £470 depending who I go with.

As this is so expensive I was wondering if anyone knows if it's definitely worth having? In my next cycle I will be having empirical steriods and anticoagulants (not sure which yet), so maybe they would be what I would be prescribed if the test was positive anyway. I am also already being tested for the below, so not sure if any of these tests would raise any alarms thrombophilia wise anyway?:

• Anti-nuclear antibodies
• Cardiolipin antibodies (immunes)
• Rheumatoid factor
• Smooth muscle (immunes)
• MITO / LKM / GPC (autoimmunes)
• Thyroid peroxidase antibodies
• Lupus anticoagulant screen
• FBC
• ESR (immunes)
• Urea and Electrolytes
• Free Androgen Index - testosterone
• Hepatic (liver)
• LH & FSH
• Oestrediol
• Progesterone
• Prolactin
• Testosterone profile
• Thyroid function panel
• Immunoglobulin panel
• DHEAS
• Antiphospholipid antibodies

Any advice please? I will also post this to fertility friends. Thank you :)

Hello - sorry to hear about your miscarriages. I know how hard it is.
Ask your GP to refer you to your local hospital fertility clinic. They will look in to recurrent miscarriages after three and part of those investigations are the thrombophilia tests, per the NICE guidelines.

Oh so sorry - after re-reading you didn't say you had had miscarriages. Sorry I should have re-read. I am not sure if they will look in to this for you on the NHS sadly.

I'm also doing karyotyping tests for me and my partner, maybe that could be an option. We'll also pgs or pgd test are remaining embryos depending on the karyotyping results. This is after 2 IVF miscarriages.

Thanks for your reply. I haven't had miscarriages, but I've had chemicals. Si almost. But I've only had 2. My first round of IVF I didn't get any eggs so there was no embryo to put back. But 2 chemicals means I'm not eligible for NHS miscarriage testing :(

I'm a poor responder and have only managed to get 3 eggs over 3 cycles, so we can't have PGS - it's a selection tool and not worth the risks to my one (if I'm lucky) embryo. We are having karyotyping this month though.

Hi @Cariad82 - I'm so sorry you haven't been successful yet, I remember you from other threads.

My GP was really helpful - I brought her a similar list of tests and she was able to arrange for most of them. I'm not sure if that's always possible but it might be worth a try - it could cut down on what you need to pay for privately.

I also did some tests abroad - NK cells etc. - as it was so much cheaper. I also did a hysteroscopy and endometrial scratch abroad as well (all in Prague) and spent half as much as I would have in the UK.

With hindsight, I needn't have bothered, as my UK clinic was happy to prescribe anticoags and prednisone empirically for my next cycle.

If your clinic is willing to do that, most of what those tests are for is covered.

Argh - sorry, I just re-read your post, and I can see that your GP is helping already!

Haha thanks @RedPandaFluff. Yes my GP have been very helpful, they just don't do a couple of the tests so I'm having to sort them privately.

I'm not doing the Level 2 immunes yet. I do actually have a note in my notes about you having had them abroad because you replied to one of my earlier posts saying that, so I know to look in to that if we do them in future. We might consider them if we fail next cycle, just for peace of mind, but my clinic is going to prescribe me empirical prednisone and anticoags for the next cycle too, so we didn't want to spend the money on the Level 2's at this point.

I have a GP referral for a hysteroscopy and laparoscopy that I'm waiting to hear back from. I'm hoping to have them over the summer then start next cycle end of September.

Never ending tests... I don't know how we all stay sane!

Hi there, could you please help me understand what Theombophilia blood tests I need to request? I am planning to do it privately but not sure where and what to request exactly. I live in London. Thanks