Experiencing a miscarriage can be emotionally and physically difficult. When pregnancy loss happens more than once, it's natural to have questions. Recurrent miscarriage does not mean a successful pregnancy is impossible.
A miscarriage is usually not caused by something you did or failed to do.
At Sehgal IVF Centre, our aim is to identify potentially treatable factors, avoid unnecessary tests or treatments, and give you an individualised plan for a future pregnancy, with care and support at every step.
of patients with recurrent pregnancy loss may have a successful subsequent pregnancy, even without a specific intervention, according to ASRM's 2026 guidance.
Individual outlook varies with factors such as age and the cause of the losses.A miscarriage is a pregnancy that ends before the stage of viability. The term recurrent pregnancy loss is used when losses occur repeatedly. Recurrent miscarriage can have several possible causes, including chromosomal abnormalities, uterine abnormalities, hormonal or metabolic conditions, antiphospholipid syndrome and other factors. In some patients, no specific cause is identified even after appropriate evaluation.
Two or more spontaneous pregnancy losses before 22 completed weeks of pregnancy.
A person with RPL may be able to conceive but has difficulty continuing a pregnancy.
Infertility primarily concerns difficulty achieving pregnancy. A person can have recurrent miscarriage without infertility.
Miscarriage is unfortunately common, particularly in early pregnancy. Many early miscarriages occur because of chromosomal abnormalities in the developing embryo, which are often random and become more common with increasing maternal age. Having one miscarriage does not necessarily mean there is an underlying problem, but repeated losses may justify a more detailed evaluation.
There is not always one single cause, and in many patients no definite cause is identified (unexplained recurrent pregnancy loss). Current guidance emphasises evidence-based evaluation rather than ordering large numbers of tests or offering treatments that haven't been shown to help. Tap a cause to learn more.
An important cause of miscarriage, particularly in the first trimester. ASRM's 2026 guidance notes that approximately 50–60% of first-trimester miscarriages are associated with embryonic aneuploidy, and the likelihood increases with maternal age.
Most are random and don't mean either parent has a genetic disorder, but in some recurrent cases testing may identify a chromosomal factor that needs further evaluation.
The shape or structure of the uterus can sometimes contribute. Examples include:
ASRM recommends uterine-cavity evaluation for patients with unexplained recurrent pregnancy loss.
An autoimmune condition associated with abnormal blood clotting and certain pregnancy complications. Testing may be recommended when your history meets appropriate criteria, and can include:
A positive antibody test doesn't automatically mean APS. Diagnosis needs clinical and laboratory criteria, and some tests may need repeating.
Thyroid disorders can affect reproductive health and pregnancy. Depending on symptoms, history and previous losses, your doctor may recommend tests such as TSH, based on your circumstances rather than every available test.
Poorly controlled diabetes can affect pregnancy. As part of preconception care, blood glucose and other metabolic factors may be assessed. Good control of existing conditions before pregnancy is an important part of planning.
In a small proportion of couples, one partner may carry a balanced chromosomal rearrangement, often without any symptoms. Parental chromosome testing may be considered in selected situations, particularly when miscarriage tissue shows an unbalanced structural abnormality or cannot be tested.
Recurrent pregnancy loss is not only a female health issue. The male partner's age, metabolic health and certain sperm-related factors may be relevant. ASRM discusses an association between elevated sperm DNA fragmentation and RPL, with testing considered in the right clinical context. A standard semen analysis may also be part of assessment. Male infertility
Recurrent miscarriage itself doesn't have a specific symptom pattern; the main concern is two or more pregnancy losses. During an individual miscarriage, symptoms may include:
However, bleeding during early pregnancy does not always mean miscarriage.
Seek urgent medical assessment if you experience:
You may consider a recurrent pregnancy loss evaluation after two pregnancy losses, rather than necessarily waiting for three. Losses don't need to be consecutive.
Evaluation is individualised, not a one-size-fits-all test panel. Your doctor may review:
Relevant factors from the male partner may also be reviewed. Recurrent pregnancy loss can involve either partner, so a complete assessment may include both.
Depending on your history, evaluation may include the tests below. Not every patient needs every test.
When tissue is available and testing is feasible, chromosome analysis can show whether the pregnancy had a chromosome abnormality. ASRM recommends array-based testing of miscarriage tissue as a first step when possible.
To identify structural abnormalities that may contribute to loss, using methods such as:
Depending on your history:
Parental karyotyping may be considered in selected cases, particularly when miscarriage testing finds a relevant abnormality or tissue can't be tested. Genetic counselling may be recommended when a chromosomal or inherited condition is suspected.
May include semen analysis, medical history, lifestyle assessment and, in selected cases, sperm DNA fragmentation testing. Discuss the need for advanced sperm testing with your specialist.
A careful, compassionate evaluation can help identify potentially treatable causes and plan for a future pregnancy, without unnecessary tests or treatments.
Treatment depends on the cause identified during evaluation. There is no single medicine or procedure that prevents every miscarriage. Here's how care is matched to what is found:
May include treating a uterine septum, submucosal fibroids, endometrial polyps, intrauterine adhesions or retained pregnancy tissue. ASRM's 2026 guidance states surgical treatment of certain uterine abnormalities may be reasonable. The decision is individualised.
If you meet the criteria for APS, treatment may involve medicines such as low-dose aspirin and heparin or another anticoagulant, under medical supervision.
Aspirin and heparin should not be taken simply because you've had miscarriages. ASRM recommends targeted evaluation and evidence-based treatment.
Appropriate treatment and preconception management of thyroid disease, diabetes or other metabolic conditions may help reduce pregnancy-related risks. Your doctor may recommend optimising these before trying again.
Helps explain what the result means, the chance of recurrence, available reproductive options, whether more testing is appropriate, and whether IVF with genetic testing could be considered, based on the specific finding.
Along with pregnancy monitoring and psychological support as part of every plan.
If you can conceive naturally and no infertility factor is present, IVF may not be necessary simply because miscarriages have occurred. It may be considered in selected situations:
PGT-A can identify some chromosome-number abnormalities in IVF embryos. Because many early miscarriages are chromosomal, it may seem an obvious solution, but it is not guaranteed and not appropriate for every patient. ASRM's 2024 guidance notes the evidence in RPL is complex and doesn't establish it should routinely replace expectant management.
If considered, your doctor should discuss:
Prevention depends on the cause. Some risk factors can be identified and treated, but not every miscarriage can be prevented, as many early losses occur because of random chromosomal abnormalities. A healthy preconception approach may include:
These support reproductive health but cannot guarantee that miscarriage will not occur.
Sometimes a complete evaluation doesn't find a clear cause. This can be frustrating when you want a specific answer, but it does not mean a future successful pregnancy is unlikely. Approximately 50–80% of patients with RPL may have a successful subsequent pregnancy without a specific intervention, although individual prognosis varies.
Your doctor may recommend:
Recurrent miscarriage can be emotionally difficult. You may experience:
It's important to understand that a miscarriage is usually not caused by something you did or failed to do. Ordinary emotional stress is not usually the cause either, but the anxiety that follows loss deserves real support.
ASRM's 2026 guidance emphasises psychological support as an important part of care. Counselling may help, particularly when grief or anxiety is affecting daily life.
It's understandable to feel anxious about becoming pregnant again. Once pregnancy occurs, your doctor may recommend appropriate early follow-up based on your history.
Our care focuses on understanding your previous losses and identifying factors that may be treatable. Where a cause is found, treatment is directed toward it; where none is found, the focus is supportive, evidence-based care and monitoring, not unnecessary treatments.
Still have questions? Call us on +91 7827219633.
Recurrent miscarriage, also called recurrent pregnancy loss, generally refers to two or more spontaneous pregnancy losses. Current ASRM guidance does not require the losses to be consecutive.
The current ASRM definition uses two or more pregnancy losses. You do not necessarily have to experience three miscarriages before discussing evaluation with a specialist.
Possible causes include chromosomal abnormalities, uterine abnormalities, antiphospholipid syndrome, thyroid or metabolic problems, genetic factors and some male factors. In many patients, no specific cause is found.
In some cases, an underlying cause can be identified and treated. For example, certain uterine abnormalities or antiphospholipid syndrome may have specific management options. However, there is no treatment that prevents every miscarriage.
Yes. Many patients with recurrent pregnancy loss subsequently have a successful pregnancy. ASRM's 2026 guidance reports that approximately 50%–80% may have a successful subsequent pregnancy, although individual prognosis varies.
No. Recurrent miscarriage does not mean that having a successful pregnancy is impossible. A fertility specialist can evaluate potential causes and discuss options for a future pregnancy.
No. Infertility concerns difficulty achieving a successful pregnancy, whereas recurrent pregnancy loss concerns repeated pregnancy losses after conception. A person can have recurrent miscarriage without infertility.
Depending on your history, evaluation may include chromosome testing of miscarriage tissue, uterine cavity evaluation, targeted blood tests, thyroid testing when indicated, antiphospholipid antibody testing when appropriate, genetic evaluation and male-partner assessment. Not every patient needs every test.
Yes. When tissue is available and testing is feasible, chromosome analysis can provide useful information about whether the pregnancy had a chromosomal abnormality. Current ASRM guidance recommends array-based chromosome testing of miscarriage tissue when possible.
Thyroid disorders can affect reproductive and pregnancy health. Your doctor may recommend thyroid testing depending on symptoms, risk factors and pregnancy-loss history.
PCOS may be associated with several reproductive and metabolic factors, but recurrent miscarriage should not automatically be attributed to PCOS. A proper evaluation is needed to identify other possible causes.
No. IVF is not automatically required simply because a patient has experienced recurrent miscarriage. It may be considered when infertility or another indication for IVF is present, or in selected genetic circumstances.
PGT-A can identify some chromosome-number abnormalities in embryos created through IVF, but it is not guaranteed to prevent miscarriage and is not routinely appropriate for every patient with recurrent pregnancy loss.
Yes. Recurrent pregnancy loss can involve factors related to either partner, so a complete assessment may include both partners.
Some evidence links increased sperm DNA fragmentation with recurrent pregnancy loss. Current ASRM guidance considers sperm DNA fragmentation testing in selected patients with recurrent unexplained pregnancy loss rather than as a universal test.
Do not start aspirin on your own. Aspirin may be appropriate in certain medical situations, such as specific cases of antiphospholipid syndrome, but it is not a universal treatment for recurrent miscarriage. Discuss it with your fertility specialist.
Progesterone treatment is not appropriate for every patient with recurrent miscarriage. Whether it has a role depends on the clinical situation and pregnancy history. Your doctor should decide whether progesterone is appropriate rather than using it routinely without assessment.
Miscarriage is usually not caused by ordinary emotional stress or something a woman did or failed to do. After recurrent miscarriage, however, emotional stress and anxiety can be significant and deserve appropriate support.
A detailed evaluation can help identify potentially treatable causes and determine whether additional testing or treatment is appropriate. If you've experienced two or more pregnancy losses, speak with a fertility specialist about evaluation and planning for a future pregnancy.
Medical disclaimer: This page is intended for general educational purposes and does not replace medical consultation, diagnosis or treatment. Recurrent pregnancy loss can have different causes, and sometimes no specific cause is identified. Testing and treatment should be individualised by a qualified fertility or reproductive-medicine specialist. If you have experienced recurrent miscarriage or are currently pregnant and have concerning symptoms, seek appropriate medical care.
