Losing a pregnancy is heartbreaking, and losing more than one can leave couples anxious and searching for answers. Recurrent pregnancy loss is a recognised condition, and investigation can sometimes find a treatable cause. Many couples go on to have a successful pregnancy.
What is recurrent pregnancy loss?
Recurrent pregnancy loss usually means two or more pregnancy losses, most often in the first trimester. Doctors may start investigations after two or three losses, depending on age and history.
What causes recurrent pregnancy loss?
Chromosomal causes
Most single miscarriages happen because the embryo has a chromosomal problem, and this becomes more common with age. In a small number of couples, one partner carries a balanced chromosomal rearrangement that increases the risk.
Uterine causes
Some women have a uterine septum, fibroids, polyps or scarring that can affect implantation. See how uterine conditions affect fertility.
Antiphospholipid syndrome
This autoimmune condition causes blood clotting problems that can affect the placenta. It is one of the most important treatable causes.
Hormonal causes
Thyroid disease, poorly controlled diabetes and PCOS are linked with a higher risk of miscarriage. See hormonal assays and PCOS and fertility.
Other factors
Age, smoking, excess weight and alcohol can increase the risk. In about half of couples, no clear cause is found.
Which tests are usually done?
- Blood tests for antiphospholipid antibodies
- Thyroid function and blood sugar tests
- A pelvic or 3D ultrasound, and sometimes hysteroscopy
- Chromosome tests (karyotype) for both partners in some cases
- Testing of pregnancy tissue, where available
What treatments are available?
- Antiphospholipid syndrome: low-dose aspirin and heparin injections in pregnancy
- Uterine septum or polyps: may be treated with hysteroscopic surgery
- Thyroid or diabetes: treatment to bring levels into a healthy range
- Chromosomal rearrangements: genetic counselling, and in some cases IVF with genetic testing of embryos. See preimplantation genetic testing
- Unexplained loss: early scans and supportive care in the next pregnancy are associated with good outcomes
Emotional support
Repeated loss affects both partners deeply. Counselling and support are an important part of care. See coping with the emotional impact.
Frequently asked questions
How many miscarriages before tests are done?
Doctors often offer investigations after two or three pregnancy losses, depending on age and history.
Can recurrent miscarriage be treated?
Some causes, such as antiphospholipid syndrome, thyroid disease and a uterine septum, can be treated. Even when no cause is found, many couples have a successful pregnancy later.
Does stress cause miscarriage?
There is no good evidence that everyday stress causes miscarriage. Most early losses are caused by chromosomal problems in the embryo.
If you have questions about your own situation, you can meet our doctors at our Basavanagudi, Koramangala and Ballari centres, or contact us to book an appointment.
This article is for general information and does not replace medical advice. Treatment decisions should be made with a qualified doctor who knows your history.