After a miscarriage, its understandable that you want to know why it happened and what could be done to stop it happening again. However, unfortunately the miscarriage testing policy only allows you to have tests or treatment after your third consecutive miscarriage. This is because most women who have one or two miscarriages will go on to have a successful pregnancy next time. At CARE, our specific recurrent miscarriage test called CAREunity can help provide you with much-needed answers and peace of mind.
CAREunity is designed to help people who have experienced repeated unexplained miscarriages or unexplained implantation failure with IVF treatment by detecting a cause. It looks at a genetic "mutation" or "variation" in a specific gene carried on chromosome no. 4.
The specific gene is Annexin A5 and is associated with and responsible for normal blood clotting in the body. The variant or mutation of this gene has the name C4M2. "C4" stands for chromosome no. 4 and "M2" is the name given to the variant at a specific location of this gene on chromosome 4.
The cells of our body usually have 23 pairs of chromosomes, including one of each pair from the egg and one from the sperm. Each chromosome carries the genes responsible for every function in our body, this is what keeps us alive and healthy.
The Annexin A5 gene is partly responsible for normal clotting in our body and the presence of the variant gene can be associated with blood clotting disorders (sticky blood). We have known for a number of years that increased clotting in the placenta can lead to miscarriage or implantation failure by reducing the blood flow to the embryo at a very early stage of its implantation in the womb.
It has also been shown that the presence of this gene in the embryo can cause other conditions from a poorly functioning placenta (due to micro-clots in the blood flow system between fetus and placenta) which can be associated with high blood pressure and small-for-dates babies.
What is new following the discovery of the Annexin A5 variant (C4M2) is that it is the presence of the variant gene in the embryo that can cause clotting problems - this is important because the embryo can inherit the variant gene from either the sperm provider or the egg provider.
This screening test can identify the presence of the Annexin A5 gene. If the gene is present in either the sperm or the egg provider then there is at least a 50% chance it will be present in the embryo.
Initial Saliva Test
Testing for it is simple, a swab is taken from the inside of the mouth of both partners and the results are available in about 3 weeks.
Treatment For Recurrent Miscarriage
If the Annexin A5 Variant is identified in either partner the woman having embryo transfer will be prescribed a blood thinning medication called Heparin, better known as Clexane. This is an under the skin injection that starts at the time of embryo transfer and continues until at least 12 weeks of pregnancy.
When you’re ready to talk about your next step, we’re here and all of our teams will be dedicated to providing you with the highest standards of care.
The CAREunity test is available at all CARE clinics - contact us to find out more.
The independent regulator of fertility treatment, the Human Fertilisation and Embryology Authority (HFEA) consider that the only way to be confident that a treatment is effective enough to be used routinely is to carry out a randomised controlled trial (RCT). In an RCT, patients are assigned randomly to two groups: a treatment group, given the new treatment and a control group, given either a well-tried treatment or a placebo.
The CAREunity test has not been subject to a Random Controlled Trial (RCT) and supporting evidence is limited. It is therefore important that you discuss with your consultant whether it is suitable for you before making a decision on whether to include the test in your treatment.