Perform karyotype of parents with family or personal history of genetic abnormalities.
Perform karyotype of the abortus in recurrent cases.
Provide genetic counseling for families with recurrent loss or familial history of genetic disease.
In patients with a high risk for recurrent, chromosomally abnormal conceptus, discuss the options of adoption, gamete donation, and PGD.
Perform APLA testing if indicated.
If APLA levels are elevated, counseling with a hematologist and a specialist in maternal fetal medicine is recommended.
Aspirin and heparin therapy may be given to patients who are diagnosed with APS.
Imaging may include HSG, hysteroscopy, ultrasonography
, and/or MRI.
Surgical correction may be required.
Cervical cultures should be obtained during the evaluation of infertility.
Empiric antibiotics should be given before invasive testing, such as HSG.
Environmental causes - Encourage life-style changes and counseling for preventable exposures.
Endocrine factors - Perform thyroid-stimulating hormone (TSH) screening in symptomatic patients.
Thrombophilic disorders - Aspirin and heparin therapy may be given for proven diagnoses.