Miscarriage and Implantation Failure Service

The IVI Midland Miscarriage and Implantation Failure Service (MIFS) is a three-step dedicated service for women who have experienced recurrent miscarriages or embryo implantation failure.  Recent advances in understanding the causes for recurrent miscarriages enable IVI Midland to offer advanced treatment options and support for patients to improve the outcome of pregnancies.

MIFS

Usual clinical best practice recommends waiting for three miscarriages – or for three failed embryo transfers – before beginning any investigations into the possible causes, but this may not be an option for some couples due to emotional, physical or financial issues or to an age-related decline in fertility.

Who may benefit?

The dedicated MIFS team of IVI Midland doctors, and clinical midwives see women who have either been referred by their GP or who have self-referred, including:

  • women who may have conceived naturally but experienced two or more miscarriages
  • women who, following fertility treatment, may have never achieved a positive pregnancy test or who have lost two or more pregnancies

What does diagnosis and treatment involve?

– Recurrent Miscarriage

Miscarriage can be emotionally and physically distressing, with about 15-20% of all pregnancies resulting in miscarriage – with higher rates in women who are more than 40 years old.  Recurrent miscarriage is defined as the loss of three or more consecutive pregnancies before 20 weeks gestation, although most occur before 12 weeks into the pregnancy.

But even after a number of miscarriages, a successful, healthy pregnancy remains possible by performing tests which may identify the cause(s) and, in turn, an effective treatment pathway. These tests are available for women suffering recurrent miscarriages after natural/ spontaneous conceptions or for those achieving pregnancies following fertility treatment.

Recent evidence suggests miscarriage may be caused by any – or a combination – of the following:

  • chromosomal abnormalities for the female or male partner or both
  • structural abnormalities of the uterus
  • endocrine (hormonal) abnormalities
  • immune disorders
  • thrombophilic (blood clotting) disorders (genetic or lifestyle induced)
  • lifestyle or environmental factors
  • idiopathic (unexplained)

The MIFS treatment pathway may vary slightly as it is tailor-made for miscarriage-only patients – with or without known fertility problems – and for current IVI Midland patients, but essentially includes the following:

Registration and assessment

After contacting IVI Midland about the MIFS service, new patients receive a form to complete details of their medical, gynaecological and obstetric history, which is then returned by post to IVI Midland.  Following a comprehensive review of these details by one of the MIFS team, the patient will be offered a telephone consultation and be given best advice about possible tests or treatment – or any other action.  An appointment may then be made for the patient to attend IVI Midland to progress any of these recommendations to screening stage.

Initial screening, which includes, as appropriate:

  • an appointment for the woman for blood-testing, including female hormone screening, as indicated by the clinical history, and a detailed transvaginal ultrasound scan
  • a clinical consultation with one of the MIFS team to review the outcome of the scan and blood tests

Other chargeable services at initial screening stage include:

  • initial tests, based on clinical need, for:
    • blood clotting conditions
    • hormone assessment
    • genetic conditions
    • a saline hysterosonogram to screen for uterine abnormalities
  • early pregnancy hormonal blood assessment and ultrasound scans

Additional screening, which is offered if no cause for miscarriage or implantation failure is diagnosed by the initial screening and includes:

  • further specialised blood tests
  • a face to face consultation with one of the MIFS team to review the outcome of the blood tests

Other chargeable services at the additional screening stage include:

  • more complex blood tests, depending on clinical need, for:
    • blood clotting conditions
    • auto-immune disorders
    • endocrine conditions
    • endometrial Natural Killer (NK) cells testing (see Midland Fertility infosheet ‘Miscarriage and Implantation Failure Diagrams’)
  • early pregnancy hormonal blood assessment and ultrasound scans

Unfortunately a few causes of recurrent miscarriage are not treatable, mainly cases with chromosomal abnormalities.  But the majority of conditions, particularly the thrombophilic factors (known as ‘sticky blood syndrome’) are treatable.  Options include hormonal treatment combined with blood-thinning tablets and/or injections on a regular basis until the woman reaches a safe period of pregnancy.

Evidence shows that early pregnancy hormone monitoring and ultrasound scanning improves the outcome in women with a history of recurrent miscarriage.

– Recurrent Implantation Failure

Implantation failure (IF) is the failure of an embryo to embed in the uterine-lining (the endometrium) in the five to seven days after conception or embryo transfer.  Women attempting natural conception may suffer repeated implantation failure and may not know that they have conceived, but may experience heavier periods before any pregnancy is confirmed.

Implantation failure may be due to factors related to:

  • the quality of the endometrium
  • embryo quality
  • a combination of different factors

Implantation failure may occur after natural conception or after fertility treatment – both result in negative pregnancy tests.

Reproductive medicine and assisted reproduction have advanced significantly over the past years.  But despite these scientific developments, at least 40-50% of treatment cycles don’t achieve a pregnancy. This can happen irrespective of age and even with good quality embryos, as seen in egg donation cycles.

Midland Fertility offers investigations for this condition and also evidence-based treatment including ‘endometrial scratching’.

What is included in the cost?

The MIFS service comprises three separate consultation packages:

  • registration and assessment – a review of written information and a phone consultation
  • initial screening – blood-taking and female hormone screening, an ultrasound scan appointment and a review consultation
  • additional screening – blood-taking appointment and a review consultation

What is not included in the cost?

  • the costs for specialist blood tests for miscarriage or implantation failure for either of the screening services vary and are charged in addition to the consultation fees. Details are available on request and according to clinical need. Patients are advised of the cost of each diagnostic test in advance and payment is required before any test begins
  • early pregnancy scans
  • any other fertility investigations, treatments or preservation services for either partner

Following the diagnosis of the cause of miscarriage or implantation failure at Midland Fertility, patients who begin any assisted conception treatment benefit from a reduced ‘conversion rate’ cost for that treatment.

Costs

Cost of the Miscarriage and Implantation Failure Service (MIFS)
registration and assessment: £250.00

Cost of the Miscarriage and Implantation Failure Service (MIFS)
endometrial scratch package: £325.00

Cost of the Miscarriage and Implantation Failure Service (MIFS)
bloods package: £850.00

Go to the Midland Fertility Cost Estimator©

More information

Go to the Midland Fertility Patient Treatment Information page and download:

  • Miscarriage and Implantation Failure Service infosheet

Also:

LU: 6/2/17/JAA