Assessing the Endometrial Environment in Recurrent Pregnancy Loss and Unexplained Infertility
Recurrent Pregnancy Loss, Unexplained Infertility
About this trial
This is an interventional treatment trial for Recurrent Pregnancy Loss
Eligibility Criteria
Inclusion/Exclusion Criteria:
Recurrent Pregnancy Loss
Inclusion:
- Age 18-45
- 3 or more SABs including biochemical pregnancies OR 2 or more SABs if one is documented to be euploid
Exclusion:
- irregular menstrual cycles
- Submucosal fibroid >3cm
- Stage 3-4 endometriosis
- BMI >40
- IUD within the last 3 months
Unexplained infertility Patients
Inclusion:
- TTC x >= 1 year
- At least one SA with TMS >10 mil within last 2 years
- At least one patent fallopian tube documented by HSG or SHG
- Cycle length 25-35 days
Exclusion:
- Irregular menstrual cycles
- Submucosal fibroid >3cm
- Stage 3-4 endometriosis
- BMI >40
- IUD within the last 3 months
- Less then 2 SABs including biochemical pregnancies
- Healthy control patients
Inclusion:
- Patients who present for fertility preservation, sex selection, same sex couples needing fertility care, preconception counseling
- 1 or more live births
Exclusion:
- Irregular menstrual cycles
- Submucosal fibroid >3cm
- Stage 3-4 endometriosis
- BMI >40
- IUD within the last 3 months
- Less then 2 SABs including biochemical pregnancies
- No history of RPL or infertility
Sites / Locations
- Reproductive Endocrinology and Infertility Center at Stanford University
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Patients with recurrent pregnancy loss or unexplained infertility
Healthy Control Patients
Patients with recurrent pregnancy loss or unexplained infertility will have an assessment of the uterine environment at the time of implantation, followed by testing of uterine endometrial gene expression using the ERA test and the uterine micro biome. Those who have abnormal results (an abnormal microbiome or an abnormal ERA) will have the option to undergo treatment followed by retesting of the uterine environment. For an abnormal ERA suggesting a pre-receptive result, luteal phase vaginal progesterone supplementation will be offered prior to re-testing of the ERA. For an abnormal microbiome a combination of oral antibiotics and vaginal probiotics will be offered prior to re-testing the uterine microbiome.
Patients who have had a normal delivery and no history of infertility or recurrent pregnancy loss will have assessment of the uterine environment at the time of implantation.