Recurrent miscarriages/pregnancy loss Home A-Z Health Information Health Library A-Z Recurrent Miscarriages/pregnancy Loss Overview Recurrent pregnancy loss is defined as the occurrence of two or more consecutive miscarriages. Though pregnancy loss is relatively common (occurring in 10–20% of known pregnancies), recurrent pregnancy loss is less frequent, affecting 1–2% of couples trying to start a family. The probability of failed pregnancy after two pregnancy losses increases with each loss. Importantly, the risk of repeated pregnancy loss increases with age. Older women with previous repeated pregnancy loss are at a much higher risk of subsequent pregnancy loss than younger women. Types Recurrent pregnancy loss is of two types:Primary recurrent pregnancy loss: This occurs in individuals who have never given birth to a live baby.Secondary recurrent pregnancy loss: This occurs in individuals who have given birth to a live baby. Causes Recurrent pregnancy loss can be attributed to many factors; the common causes for this condition include:Chromosomal abnormalities: Genetic issues might make it impossible for the embryo to develop properly. These issues account for more than half of the recurrent pregnancy loss cases.Uterine abnormalities: Structural problems in the uterus, like uterine fibroids, scar tissue, or an abnormally shaped uterus, can prevent the pregnancy from continuing. Approximately, 10‒15% of the women with multiple pregnancy losses have uterine anomalies.Hormonal imbalance: Certain conditions like polycystic ovary syndrome (PCOS), thyroid disorders, and luteal phase defects, cause imbalances in the levels of reproductive hormones, such as luteinising hormone (LH), insulin, thyroid-stimulating hormone (TSH), and progesterone; this, in turn, complicates the maintenance of the pregnancy.Blood clotting disorders (Thrombophilia): Certain conditions cause blood to clot more easily (blood clotting disorders), resulting in interference with the ability of the placenta to nourish the baby. These conditions are therefore a major cause of pregnancy complications, including recurrent pregnancy loss.Immune system disorders: In addition to the maternal molecules, the foetus contains paternal and ‘self’ molecules; some immune system-related disorders, such as lupus, may increase the risk of recurrent pregnancy loss as they cause the mother’s immune system to consider the paternal and ‘self’ molecules as foreign and thus, attack the foetus.Maternal health conditions: Chronic illnesses, such as diabetes or unmanaged hypertension, have been shown to increase the risk of repeated pregnancy loss.In some cases, the cause of recurrent miscarriages may remain unknown (idiopathic) even after thorough testing. Symptoms Recurrent pregnancy loss shares many symptoms with miscarriage; these include:Vaginal bleeding.Cramping or pain.However, in some cases, pregnancy loss occurs silently without any noticeable symptoms. Diagnosis Ultrasound: A pelvic ultrasound can check for uterine abnormalities—such as fibroids, polyps, or septum—that suggest a risk of miscarriage.Hysteroscopy: In this procedure, a small camera is used to visually examine the inside of the uterus for structural issues. It can be used to determine the cause of repeated miscarriages.Hormonal tests: The serum levels of progesterone, thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH), prolactin, oestradiol, and anti-Mullerian hormone (AMH) are evaluated to diagnose recurrent pregnancy loss.Blood clotting tests: As clotting disorders are a major cause of recurrent pregnancy loss; blood clotting tests are used to check for clotting disorders. Autoimmune tests: If there is a suspicion of immune system involvement, doctors might perform tests to screen for lupus anticoagulant, anti-beta2 glycoprotein I (IgG and IgM), and anticardiolipin antibodies (IgG and IgM) to check if your body is attacking its own tissues or the pregnancy.Genetic testing: The chromosomes of both parents can be checked (karyotyping) to look for any underlying genetic issues that can result in recurrent pregnancy loss. Treatment The treatment for recurrent pregnancy loss depends on the cause. Generally, one or more of the following treatment options may be considered:Chromosomal issues: If a genetic problem is identified, preimplantation genetic testing (PGT) during IVF may be recommended to ensure only healthy embryos are implanted.Uterine abnormalities: If structural problems—such as fibroids or septa—are found, surgery may be an option to correct the issue.Hormonal imbalance: For conditions like PCOS or thyroid disorders, managing the hormone levels with medications can help regulate the pregnancy cycle and support a healthy pregnancy.Blood clotting disorders: Blood thinners, such as aspirin or heparin, can be prescribed to help improve blood flow to the placenta, thereby reducing the risk of miscarriage.Autoimmune problems: If immune system problems are suspected, treatments that dampen the immune response might be recommended.Sometimes, lifestyle changes that include sustaining a healthy weight, controlling diabetes, and quitting smoking can significantly increase your chances of carrying a pregnancy to full term. When to see a doctor Early intervention, after just two miscarriages, can help you get the support and testing you need sooner.