Karyotyping
- What it uncovers
- Chromosomal rearrangements in either partner that can be passed to an embryo.
- How it is performed
- A simple blood test from both partners.
The diagnostic pathway
“Unexplained” loss is rarer than it sounds.
A pregnancy loss called “unexplained” almost always means the right tests were never run — not that no reason exists. At EPIA we investigate five areas together — genetic, immune, clotting, uterine and endometrial — until we find a cause we can actually act on.
- Two or more losses reviewed
- 28+ diagnostic tests
- Answers within one workup
Fertility specialist reviewing diagnostic reports with a couple
What a thorough workup finds
Most “unexplained” losses have a reason we can name.
When the investigation is complete rather than partial, a cause usually surfaces. These are the numbers behind our approach.
2,400+
couples given a clear, named reason after a full review.
28+
diagnostic tests across five areas of investigation.
5
areas reviewed together, so a cause is not missed in isolation.
40+ yrs
of combined reproductive-medicine experience behind every review.
Five areas of investigation
We look everywhere the answer could be.
Each area below explains what we check, why it matters, and exactly how each test is done. Jump to any area, or read straight through.
Chromosome karyotype and a blood sample for genetic screening
01
Investigation 01
Genetic
A large share of early losses trace back to the chromosomes — either a rearrangement carried by one partner, or an error that arises in the embryo itself. We check both, so a treatable genetic cause is never assumed away.
PGT-A
- What it uncovers
- Whether embryos created through IVF carry the right number of chromosomes.
- How it is performed
- A small sample is taken from the embryo during an IVF cycle and screened.
Immune cells and thyroid markers around an early embryo
02
Investigation 02
Immune
Pregnancy asks the immune system to tolerate a life that is half unfamiliar. When that tolerance tips out of balance — or the thyroid turns on itself — an otherwise healthy pregnancy can be lost. These tests read that balance.
HLA / KIR typing
- What it uncovers
- How the maternal immune system is likely to respond to the embryo.
- How it is performed
- A blood test from both partners.
Thyroid antibodies (Anti-TPO)
- What it uncovers
- Autoimmune thyroid activity that can affect an early pregnancy.
- How it is performed
- A single blood test.
APLA screening
- What it uncovers
- Antiphospholipid antibodies linked to clotting and repeated loss.
- How it is performed
- A blood test, usually repeated to confirm.
Blood flow to the placenta and a clotting-factor panel
03
Investigation 03
Clotting
Micro-clots can quietly throttle the blood supply the placenta depends on, long before anything feels wrong. A thrombophilia workup looks for the inherited and acquired clotting tendencies behind that.
Thrombophilia panel
- What it uncovers
- Inherited or acquired clotting tendencies that can restrict placental blood flow.
- How it is performed
- A blood test.
3D ultrasound and hysteroscopy view of the uterine cavity
04
Investigation 04
Uterine
The shape and interior of the uterus decide whether an embryo has the room and the surface it needs. Imaging reveals septa, fibroids, polyps and adhesions that a standard scan can miss.
3D ultrasound
- What it uncovers
- The shape of the uterus and structural issues such as a septum.
- How it is performed
- A non-invasive scan in the clinic.
Hysteroscopy
- What it uncovers
- Fibroids, polyps or adhesions inside the uterine cavity.
- How it is performed
- A thin camera is used to view the inside of the uterus.
Endometrial lining sample under receptivity analysis
05
Investigation 05
Endometrial
The lining has to be receptive at exactly the right moment, healthy in its tissue, and free of the quiet infection and bacterial imbalance that can block implantation. We read all of it.
ERA
- What it uncovers
- The precise window when the lining is most receptive to an embryo.
- How it is performed
- A small sample of the lining is taken and analysed.
ALICE
- What it uncovers
- Chronic infection in the lining that can quietly prevent implantation.
- How it is performed
- Analysed from an endometrial sample.
EMMA
- What it uncovers
- The balance of bacteria in the lining that supports implantation.
- How it is performed
- Analysed from an endometrial sample.
Endometrial biopsy
- What it uncovers
- The health and structure of the lining tissue itself.
- How it is performed
- A small sample is taken during a clinic visit.
A careful next step
Ready to find your reason?
Speak with a fertility coach about which reports to bring, which tests may be missing, and what a complete evaluation looks like for you. Confidential, with a response within one working day.
The information on this page is educational and does not replace individual clinical advice. Outcomes vary between patients; nothing here guarantees pregnancy, egg quality, or treatment success.