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Nine-marker hormonal screen targeting the treatable hormonal contributors to recurrent pregnancy loss.
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A nine-marker hormonal screen for women who have experienced two or more pregnancy losses — assessing thyroid antibodies, TSH, prolactin, progesterone, FSH.
Recurrent miscarriage — defined as two or more pregnancy losses — affects approximately 1% of couples. While chromosomal abnormalities account for around 50 to 60% of individual early losses, recurrent miscarriage often has hormonal contributors that are identifiable and, in many cases, treatable.
The Recurrent Miscarriage Hormonal Screen targets the key hormonal risk factors for recurrent loss:
Thyroid: TSH and TPO antibodies — even subclinical hypothyroidism (TSH above 2.5 mIU/L) and elevated TPO antibodies with normal thyroid function are independently associated with increased miscarriage risk. Treating elevated TSH before and during conception significantly reduces this risk.
Prolactin: hyperprolactinaemia causes anovulation, poor luteal phase quality, and is associated with recurrent miscarriage.
Progesterone: mid-luteal progesterone confirms ovulation occurred and assesses luteal phase adequacy — a recognised contributor to recurrent loss.
Reproductive hormones: FSH, LH, oestradiol to assess ovarian function and PCOS features, and testosterone to screen for androgen excess. AMH assesses ovarian reserve — relevant for understanding fertility trajectory alongside recurrent loss.
Venous draw required; cycle-timed. GMC-physician reviewed results within 5 to 7 working days.
Understand what each marker measures, why it matters, and what the science says — not just a list of numbers.
Target TSH below 2.5 mIU/L in women trying to conceive; higher TSH is associated with increased miscarriage risk.
Elevated TPO Ab independently increases miscarriage risk even when thyroid function is normal; warrants monitoring.
Elevated prolactin impairs luteal phase quality and is associated with recurrent early pregnancy loss.
Day 2 to 5 baseline; elevated FSH suggests declining ovarian reserve relevant to fertility planning after losses.
Day 2 to 5 baseline; elevated LH may indicate PCOS, which is associated with higher miscarriage rates.
Day 2 to 5 baseline; contextualises FSH and identifies follicular phase hormonal environment.
Day 21 measurement; low progesterone suggests anovulation or luteal phase deficiency.
Elevated testosterone in PCOS is associated with higher miscarriage rates even when ovulation occurs.
Ovarian reserve marker; low AMH informs fertility timeline discussions following recurrent loss.
This panel is designed for adults who want a comprehensive, evidence-based picture of their metabolic health — not a GP referral panel.
Women who have experienced two or more pregnancy losses
Those with unexplained recurrent miscarriage seeking hormonal investigation
Women planning to try to conceive again after losses who want a comprehensive hormonal baseline
Those under care of a miscarriage clinic wanting private complementary testing
Hormonal causes account for a subset of recurrent miscarriage; chromosomal abnormalities in the embryo, antiphospholipid syndrome, uterine abnormalities, and unexplained causes are also significant contributors. A complete recurrent miscarriage investigation includes: APLA testing (antiphospholipid antibodies — not included in this panel), parental karyotyping, and pelvic ultrasound. This panel provides the hormonal component of that investigation. Normal results do not exclude a hormonal cause; some hormonal patterns are only apparent in multiple cycles. Please share results with your GP or recurrent miscarriage specialist (RCOG-accredited clinics are available across the UK).
From order to physician-reviewed report in as little as three working days.
Three options designed to fit your schedule, location, and preference — all producing a laboratory-standard sample.
Adults 18+ in mainland UK. Not suitable if you have had a transfusion in the last 3 months.
Order anytime; kit dispatched within 24 hours Mon–Fri.
Allow 24–48 hours for sample transit on top of lab processing time.
Adults 18+ within 20 miles of a serviced city centre.
Mon–Sun, 06:00–20:00. Next-day booking typical.
Sample reaches the lab within 24 hours of collection.
Adults 16+ with photo ID. Paediatric draws by appointment at selected sites.
Mon–Fri, with Saturday hours at most metropolitan locations.
Samples processed same-day at the receiving clinic.
Every test is processed in a UKAS ISO 15189-accredited laboratory, overseen by GMC-registered physicians, and governed by UK GDPR. No overseas processing, no offshore data.
Follow these guidelines to ensure accurate, reproducible results. Most markers are sensitive to recent food, exercise, and sleep.
Can't find your answer? Our clinical support team is available Monday to Friday, 9am–5pm.
Contact supportElevated TPO antibodies are associated with a 2 to 3 times increased risk of miscarriage, even in women who have normal thyroid function (normal TSH and FT4). The mechanism is not fully understood, but may involve immune dysregulation that extends beyond the thyroid, affecting the uterine immune environment that is critical for implantation and early placentation. Studies have shown that women with elevated TPO antibodies and recurrent miscarriage have better pregnancy outcomes when treated with levothyroxine to keep TSH below 2.5 mIU/L, and some evidence supports low-dose aspirin and progesterone supplementation in this group.
Progesterone is essential for maintaining the uterine lining after ovulation, supporting implantation, and sustaining early pregnancy until the placenta takes over progesterone production at around 8 to 10 weeks. Inadequate progesterone production in the luteal phase (luteal phase deficiency) has been proposed as a cause of early pregnancy loss. While the evidence for progesterone supplementation reducing miscarriage risk in all women is mixed, the PRISM and PROMISE trials found significant benefit in women with unexplained recurrent miscarriage who received progesterone supplementation — with the greatest benefit seen in those who had experienced more previous losses.
Women with PCOS have higher rates of miscarriage than the general population — with some studies reporting rates 30 to 50% above average. Several mechanisms are implicated: elevated LH may impair oocyte quality; elevated testosterone may create a hostile uterine environment for implantation; insulin resistance may impair endometrial receptivity and luteal phase support; and ovulatory dysfunction can produce poorer-quality embryos. Treating insulin resistance (with metformin in some women) and optimising BMI can reduce miscarriage rates in women with PCOS.
Antiphospholipid syndrome (APS) is an autoimmune condition in which antibodies against phospholipids (particularly lupus anticoagulant, anticardiolipin antibodies, and anti-beta-2-glycoprotein I antibodies) increase the risk of blood clots in the placenta, causing recurrent miscarriage. APS is responsible for approximately 15 to 20% of recurrent miscarriage cases and is treatable with low-dose aspirin and low-molecular-weight heparin during pregnancy. Antiphospholipid antibody testing is NOT included in this hormonal panel — it requires a separate test and is most appropriately arranged through your GP or recurrent miscarriage specialist.
Yes. If you have experienced two or more pregnancy losses, referral to a recurrent miscarriage clinic is appropriate in the UK. The RCOG recommends investigation after three losses (or two if you are over 35 or have other risk factors). Many NHS trusts now offer referral after two losses. Recurrent miscarriage clinics provide comprehensive investigation including APS testing, pelvic ultrasound, and parental karyotyping — alongside hormonal assessment. This Trupoint Health panel provides the hormonal component that supports those conversations and investigations. Your physician report will advise on the urgency and route of referral based on your results.
