When the Cause Lies Beyond Hormones Alone
Not every fertility challenge traces back to a hormonal imbalance. Recurrent miscarriage, male factor infertility, genetic incompatibility between partners, and pregnancy-related infections all require a different category of testing entirely, one that looks at immune function, chromosomes, and the health of both partners rather than a single hormonal panel.
This guide covers that specialist testing category at Altus Lab. If you’re earlier in your fertility journey investigating cycle regularity, ovarian reserve, or suspected PCOD, read our companion guide to fertility hormone testing covering that starting panel.
Every test here is supervised by Dr. Alok Gupta, MD Pathology, Ex-PGIMER Chandigarh, with home sample collection available across Chandigarh, Mohali, and Panchkula for blood-based tests.
Anti-Cardiolipin (IgM & IgG) & Lupus Anticoagulant
This combined test, often called the APLA Workup, screens for antiphospholipid antibodies, immune markers strongly associated with recurrent pregnancy loss, particularly later miscarriages, and increased risk of blood clots during pregnancy that can affect placental blood flow and fetal development.
Antiphospholipid Syndrome represents one of the most treatable causes of recurrent miscarriage once correctly identified, since specific blood-thinning treatment during subsequent pregnancies can significantly improve outcomes for patients who test positive. This makes accurate testing genuinely important rather than simply diagnostic.
At Altus Lab, we recommend this workup for anyone with two or more pregnancy losses, particularly losses occurring after the first trimester, since identifying this treatable condition before your next pregnancy attempt can meaningfully change your outcome with appropriate medical management.
Beta-2 Glycoprotein-1 Antibody (IgM & IgG)
Beta-2 Glycoprotein-1 Antibody testing complements Anti-Cardiolipin and Lupus Anticoagulant testing, together forming the complete diagnostic criteria for Antiphospholipid Syndrome. Testing all three markers together, rather than any single one alone, provides the diagnostic confidence needed for this important recurrent pregnancy loss investigation.
Some patients test positive for this specific antibody while showing negative or borderline results on the other two markers, making comprehensive testing essential rather than relying on partial antibody panels that might miss a genuine case of Antiphospholipid Syndrome affecting pregnancy outcomes.
At Altus Lab, we always process this test alongside the other APLA markers as a complete panel, ensuring your fertility specialist receives the full antibody picture required for accurate diagnosis rather than an incomplete, potentially misleading partial result.
Uterine NK Cell Panel (CD56+CD16–)
The Uterine NK Cell Panel examines a specific type of immune cell present in the uterine lining, investigating whether abnormal immune activity might be contributing to implantation failure or recurrent pregnancy loss in cases where other more common causes have already been ruled out.
This remains a more specialised, sometimes debated area of reproductive immunology, typically reserved for patients who have experienced multiple unexplained losses or repeated implantation failure during fertility treatment, after standard investigations including hormonal, genetic, and anatomical causes have been thoroughly explored.
At Altus Lab, we offer this specialised panel for patients whose fertility specialist specifically recommends this investigation, recognising that this testing serves a particular role in complex, otherwise unexplained cases rather than as a routine component of standard fertility evaluation.
Chromosome Karyotyping (Couple)
Chromosome Karyotyping examines the complete chromosomal makeup of both partners, identifying structural rearrangements that, while often causing no health effects for the carrying partner themselves, can significantly increase the risk of miscarriage or chromosomal abnormalities in pregnancies conceived together.
This test becomes particularly relevant after recurrent pregnancy loss, since a small but meaningful proportion of couples experiencing repeated miscarriage carry a balanced chromosomal rearrangement in one partner, information that directly influences future family planning discussions, including potential genetic counselling and specialised IVF techniques.
At Altus Lab, we recommend testing both partners together whenever karyotyping is pursued, since this condition can originate from either partner, and complete information for both individuals gives genetic counsellors the full picture needed for accurate risk assessment and family planning guidance.
Semen Analysis (WHO 2021 Criteria)
Semen Analysis remains one of the most fundamental, yet frequently overlooked, tests in fertility investigation, evaluating sperm count, motility, morphology, and several other parameters against internationally standardised WHO reference values, the most recent update reflecting current global research and clinical evidence.
Male factor infertility contributes to a substantial proportion of couples’ fertility challenges, making this test an essential, relatively simple starting point that should generally accompany female fertility testing rather than being investigated only after female causes have been thoroughly explored first.
At Altus Lab, we follow current WHO 2021 criteria precisely for this analysis, ensuring your results reflect the most up-to-date clinical standards. We recommend appropriate abstinence period guidance before collection, which our team will explain clearly when you book this test.
Sperm DNA Fragmentation (SDF) Index
Sperm DNA Fragmentation testing looks beyond basic semen parameters, examining the genetic integrity of sperm DNA itself. Even when standard semen analysis appears entirely normal, elevated DNA fragmentation can still contribute to fertility challenges, recurrent miscarriage, and reduced success rates with fertility treatments.
This test proves particularly valuable for couples experiencing unexplained infertility or recurrent pregnancy loss despite normal female fertility testing and normal standard semen parameters, since it investigates a dimension of male fertility that conventional semen analysis simply cannot assess.
At Altus Lab, we recommend this test for couples with unexplained fertility challenges or recurrent loss where standard testing hasn’t identified a clear cause, since elevated DNA fragmentation, once identified, can guide lifestyle modifications and treatment approaches aimed at improving sperm quality.
TORCH Panel (IgM & IgG)
The TORCH Panel screens for Toxoplasma, Rubella, Cytomegalovirus, and Herpes infections, testing both IgM, indicating recent or active infection, and IgG, indicating past exposure or immunity. These infections can affect pregnancy outcomes and fetal development if active during pregnancy, particularly during early stages.
This test serves two important purposes: pre-conception screening helps identify immunity status, allowing vaccination where appropriate before pregnancy, such as for Rubella, while testing during pregnancy helps investigate concerning symptoms or ultrasound findings that might suggest an active infection requiring specific management.
At Altus Lab, we recommend TORCH panel testing during pre-conception planning whenever possible, since identifying non-immune status before pregnancy allows time for protective vaccination, a much better scenario than discovering susceptibility only after conception has already occurred.
Complete Antenatal Panel
Our Complete Antenatal Panel combines CBC, blood group and Rh typing, HIV, VDRL for syphilis, HBsAg for Hepatitis B, TSH, blood sugar, and urine routine examination into a single comprehensive first-trimester screening panel, covering the essential tests every pregnancy requires at the initial prenatal visit.
Rather than ordering these individually across multiple visits, this combined approach ensures nothing gets overlooked during the busy early weeks of pregnancy, while also being more convenient and often more economical than separate individual test bookings spread across several appointments.
At Altus Lab, we designed this panel specifically around standard antenatal care guidelines, giving your obstetrician the complete baseline picture needed to guide your pregnancy care from the very first visit, with home collection available to make this crucial early testing as convenient as possible.
Cervical Cancer Screening (Pap Smear + HPV DNA High-Risk)
This combined screening approach pairs traditional Pap smear cytology, examining cervical cells for abnormal changes, with HPV DNA testing for high-risk viral strains, the primary cause of cervical cancer. Together, these tests provide significantly more comprehensive screening than either method used alone.
Combined screening allows for longer intervals between tests for women with normal results on both components, while also catching early changes that either test alone might occasionally miss. This approach reflects current international best practice for cervical cancer prevention and early detection.
At Altus Lab, we recommend this combined screening for all women within the recommended age range according to current guidelines, since cervical cancer remains one of the most preventable cancers when abnormal changes are identified and addressed at an early, highly treatable stage.
HE-4 with ROMA Index
HE-4, a protein sometimes elevated in ovarian cancer, becomes considerably more useful when combined with CA-125 and menopausal status to calculate the ROMA Index, a risk assessment tool that helps stratify the likelihood of malignancy when an ovarian mass has been identified on imaging.
This combined approach helps guide clinical decision-making, distinguishing between masses more likely to be benign, appropriate for conservative monitoring, versus those with higher malignancy risk that warrant more urgent specialist evaluation and potentially surgical intervention rather than a watch-and-wait approach.
At Altus Lab, we recommend this test specifically when an ovarian mass has already been identified through imaging, providing your gynaecologist or gynae-oncologist with additional risk stratification information to guide the appropriate next steps in your specific clinical situation.
NIPT
Non-Invasive Prenatal Testing analyses fetal DNA fragments circulating in maternal blood, screening for common chromosomal conditions including Down syndrome, with remarkably high accuracy, all without any risk to the pregnancy, unlike invasive procedures such as amniocentesis that carry a small miscarriage risk.
This test has genuinely transformed prenatal screening, offering expectant parents highly accurate information from as early as 10 weeks of pregnancy through a simple blood draw. While NIPT remains a screening test rather than a diagnostic one, its accuracy significantly reduces unnecessary invasive testing for most patients.
At Altus Lab, we offer NIPT for expectant mothers seeking accurate, non-invasive chromosomal screening, with results helping guide whether further diagnostic testing might be appropriate, giving families meaningful information during pregnancy with a straightforward, risk-free blood test.
How to Book Recurrent Loss, Male Fertility & Prenatal Testing at Altus Lab
Several tests in this category, including semen analysis and karyotyping, require specific sample handling. Call or WhatsApp our team, share your doctor’s prescription, and we will confirm the correct process for each test you need.
📞 Call: 0172-5017001 / 0172-5017002
💬 WhatsApp: +91-62842-14977
📍 SCO 35, Sector 16-D, Chandigarh
🕐 Open 7 Days: 7:30 AM – 9:30 PM
Home sample collection is available for blood-based tests across Chandigarh, Mohali, and Panchkula.
Frequently Asked Questions
1. How many antibody tests make up the complete APLA workup?
The complete workup includes Anti-Cardiolipin IgM and IgG, Lupus Anticoagulant, and Beta-2 Glycoprotein-1 IgM and IgG. All are typically tested together for accurate diagnosis.
2. Does an abnormal karyotype mean we cannot have children?
No. Many couples with a balanced chromosomal rearrangement can still conceive successfully, though genetic counselling and sometimes specialised IVF techniques may improve outcomes and reduce miscarriage risk.
3. What abstinence period is needed before semen analysis?
Generally 2 to 5 days of abstinence is recommended for accurate results. Our team will confirm specific guidance based on WHO 2021 criteria when you book.
4. Can Sperm DNA Fragmentation testing be normal even with abnormal semen analysis?
Results can vary independently between the two tests, which is exactly why both provide complementary rather than duplicate information about male fertility.
5. When is the best time to get TORCH panel testing?
Pre-conception testing is ideal, allowing time for protective vaccination if you’re non-immune to conditions like Rubella before you become pregnant.
6. Is NIPT a diagnostic test or a screening test?
NIPT is a highly accurate screening test, not a diagnostic one. Positive results are typically followed by diagnostic confirmation through your obstetrician’s guidance.
7. How often should I get cervical cancer screening?
Screening intervals depend on your age, results history, and current guidelines. Your gynaecologist will advise the appropriate frequency based on your individual results.
8. Who supervises these tests at Altus Lab?
All recurrent pregnancy loss, male fertility, and prenatal tests are supervised by Dr. Alok Gupta, MD Pathology, Ex-PGIMER Chandigarh, ensuring accurate, clinically reviewed reporting.