Losing a pregnancy is heartbreaking. Losing more than one can leave you anxious, exhausted and asking “why me?”. Please know that it is not your fault, and most couples who have had repeated miscarriages go on to have a healthy baby. This guide explains what recurrent miscarriage is, why it happens, which tests help and the treatments that make a difference. If you need personal advice, our gynaecology team in Ahmedabad offers a dedicated, unhurried consultation.
What Is Recurrent Miscarriage?
The European Society of Human Reproduction and Embryology (ESHRE) defines recurrent pregnancy loss as the loss of two or more pregnancies before 24 weeks (ESHRE guideline, 2022 update). Ectopic and molar pregnancies are not counted. Some guidelines use three losses, but most doctors now start investigations after two.
Common Causes
In about half of couples, no clear cause is found even after full testing. When a cause is found, it is usually one of these:
| Cause | What it means |
| Chromosome problems in the embryo | The most common reason for a single miscarriage; more frequent with the woman’s age |
| Parental chromosome changes | A balanced translocation in either partner (uncommon) |
| Antiphospholipid syndrome (APS) | An autoimmune condition causing blood clots in the placenta |
| Uterine shape problems | A septum, fibroids or adhesions inside the uterus |
| Thyroid disorders and diabetes | Poorly controlled hormones or blood sugar |
| Lifestyle factors | Smoking, heavy alcohol, obesity and very high caffeine, in both partners |
| Sperm DNA damage | High DNA fragmentation in the male partner may play a role |
Tests Doctors Recommend
After two losses, a structured work-up looks for treatable causes:
- Detailed history of each pregnancy and both partners’ health.
- Antiphospholipid antibody tests (lupus anticoagulant, anticardiolipin and anti-β2-glycoprotein antibodies), repeated after 12 weeks if positive.
- Thyroid tests — TSH and thyroid antibodies.
- Pelvic ultrasound (often 3D) to check the shape of the uterus; hysteroscopy if a problem is suspected.
- Genetic testing of the pregnancy tissue after a loss, when possible; parents’ chromosomes (karyotype) in selected cases.
- Male partner assessment — lifestyle, age and, in some cases, sperm DNA fragmentation testing.
Some tests sold online or in packages — for example routine “immune” panels — are not recommended by current guidelines. Ask your doctor what each test will change in your treatment.
Treatment Options
Treating a specific cause
- Antiphospholipid syndrome: low-dose aspirin and heparin injections during pregnancy, under close supervision
- Uterine septum, polyps or fibroids: hysteroscopic or laparoscopic correction where appropriate
- Thyroid disease or diabetes: good control before and during pregnancy
- Parental chromosome change: genetic counselling and, in some cases, IVF with pre-implantation genetic testing (PGD)
When no cause is found
This is called unexplained recurrent miscarriage, and the outlook is often good. Helpful steps include:
- Early pregnancy support — early scans and regular reassurance visits
- Vaginal progesterone — the ESHRE 2022 update says it may be considered for women with three or more losses who have bleeding in a new pregnancy
- Lifestyle changes for both partners — stop smoking, limit alcohol, reach a healthy weight. Men can follow our sperm-quality tips
- Folic acid before conception and in early pregnancy
Myths and Facts About Miscarriage
| Myth | Fact |
| Working, lifting or travelling caused my miscarriage | Normal daily activity does not cause miscarriage |
| Sex in early pregnancy causes miscarriage | Intercourse does not cause miscarriage in a healthy pregnancy |
| Strict bed rest prevents miscarriage | Bed rest has not been shown to prevent miscarriage |
| One miscarriage means something is wrong with me | A single miscarriage is common and usually due to a one-off chromosome problem in the embryo |
| Nothing can be done after repeated losses | Testing finds treatable causes in many couples, and most go on to have a baby |
What Are Your Chances of a Healthy Baby?
Most couples with recurrent miscarriage, including those with no cause found, have a successful pregnancy in the future. Chances are best for younger women and those with fewer previous losses. Your doctor can estimate your personal chance using your age and pregnancy history.
What Happens at Your First Consultation
Your first visit focuses on understanding your story. Bring the reports from each pregnancy — scan reports, blood tests and any genetic results from pregnancy tissue. The doctor will take a detailed history from both partners, examine you, plan the blood tests and an ultrasound, and explain what each test can show. Most results are back within one to two weeks, and you then sit down together to agree a plan for the next pregnancy.
When to Seek Urgent Care in Early Pregnancy
Go to the hospital straight away if you have heavy bleeding (soaking a pad in an hour), severe abdominal pain, pain in the shoulder tip, dizziness or fainting. These can be signs of a miscarriage needing treatment or an ectopic pregnancy.
How We Support Your Next Pregnancy
At Lifeline, care after recurrent miscarriage is planned before you conceive. We complete the recommended tests, treat any cause we find, and agree a plan for the next pregnancy — including when to start medicines if needed, an early first scan, and regular reassurance visits in the first trimester. Because our gynaecology, fertility and maternity teams work in the same hospital, you stay with familiar doctors from the first positive test to delivery.
Caring for Your Emotional Health
Grief, anxiety and fear in the next pregnancy are normal. Talk openly with your partner, ask for counselling if you need it, and choose a team that will see you early and often. You do not have to go through it alone.
Planning Your Next Pregnancy
- Complete the recommended tests before trying again
- Start folic acid at least one month before trying
- Control thyroid, blood sugar and blood pressure
- Book an early scan as soon as your test is positive
- Consider high-risk pregnancy care at a maternity hospital that can see you quickly
| Had two or more miscarriages? Book a recurrent pregnancy loss consultation with Dr. Maulik Shah at Lifeline Women’s Hospital, Gota. Call +91 98988 66044 or book online. |
Frequently Asked Questions
After how many miscarriages should I get tested?
Most doctors now recommend testing after two miscarriages, in line with the ESHRE guideline.
Is recurrent miscarriage the mother’s fault?
No. Most miscarriages are caused by chromosome problems in the embryo, which nobody can control. Both partners’ health matters too.
Can stress cause miscarriage?
Everyday stress has not been shown to cause miscarriage. Looking after your emotional health is still important.
Does progesterone prevent miscarriage?
Vaginal progesterone may help women with three or more previous losses who bleed in early pregnancy. Your doctor will advise whether it is right for you.
Can IVF help with recurrent miscarriage?
IVF does not prevent miscarriage on its own. It may help when a parental chromosome change is found, by allowing embryos to be tested with PGD.
When can I try again after a miscarriage?
Many women can try after their next normal period if they feel ready, but complete any recommended tests first. Ask your doctor about your situation.
Author & Medical Review
Dr. Maulik Shah MBBS, MS (Obstetrics & Gynaecology) — Diploma in Infertility (Germany) | Consultant Gynaec & Infertility Specialist. Medically reviewed by Dr. Maulik Shah.
