Recurrent Miscarriage: Causes and Tests
This article explores a guide to recurrent miscarriage, including the definition, known causes, investigations you may be offered, and treatments that can help. We cover what you need to know in plain language.
Table of Contents
Definition and Known Causes
Recurrent miscarriage is defined in the UK as three or more consecutive losses before 24 weeks. About one in a hundred couples experience this. Even after three losses, the chance of a successful next pregnancy remains around 50 to 75 percent, so the outlook is far from bleak. Known causes include antiphospholipid syndrome, a clotting disorder that affects blood flow to the placenta and can be treated with aspirin and heparin; inherited thrombophilias; structural problems of the uterus such as a septum or fibroids; and parental chromosomal rearrangements, where one partner carries a balanced translocation. Some cases are linked to uncontrolled diabetes, thyroid disease, or high natural killer cells, though the evidence for the latter is limited. In around half of cases, no cause is found, which is frustrating but also means there is no identified barrier to success.Tests and Treatments
After three losses, your GP can refer you to a recurrent miscarriage clinic. Tests usually include blood tests for antiphospholipid syndrome, inherited thrombophilias, thyroid function, and diabetes; karyotyping of both partners to check for translocations; and a pelvic ultrasound or hysteroscopy to examine the uterus. Some clinics offer more specialised tests, though not all are proven. Treatment depends on the cause: aspirin with low molecular weight heparin for antiphospholipid syndrome; surgical correction of uterine problems; optimising control of diabetes or thyroid disease; and, where a translocation is found, genetic counselling. Where no cause is identified, supportive care with early scans and close monitoring improves outcomes. Research continues into areas such as progesterone supplementation, which some studies suggest may help in certain groups.FAQ
### How many miscarriages count as recurrent?In the UK, three or more consecutive losses before 24 weeks is defined as recurrent miscarriage. After three, referral for investigations is recommended.
Can recurrent miscarriage be treated?
Yes, when a cause is found. Treatments include aspirin and heparin for antiphospholipid syndrome, surgery for uterine problems, and optimising control of diabetes or thyroid disease.
What is the chance of success after recurrent miscarriage?
Even after three losses, the chance of a successful next pregnancy is around 50 to 75 percent, higher if a treatable cause is identified and managed.
This article is for informational purposes only and does not constitute medical advice.
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