Recurrent miscarriage, also known as recurrent pregnancy loss, is typically defined as having two or more consecutive pregnancy losses before 20 weeks of gestation. While miscarriage is more common than many people realize—occurring in about 10-20% of known pregnancies—experiencing multiple losses can be devastating, both physically and emotionally. For women and couples trying to grow their families, repeated miscarriages can bring a profound sense of grief, confusion, and fear about the future. At May-Grant OB/GYN, our team of providers across Lancaster and surrounding areas is committed to helping patients navigate this journey with compassionate care and a focus on answers.
Many women blame themselves when miscarriage happens, but in most cases, it is not the result of something the mother did or did not do. It’s important to remember that miscarriage often stems from biological or medical causes that are outside of anyone’s control. Understanding the underlying reasons for recurrent miscarriage can provide relief from self-blame and open the door to possible treatments and preventative strategies for future pregnancies.
Understanding the Causes of Recurrent Miscarriage
The causes of recurrent miscarriage are diverse and sometimes complex. One of the most common causes is chromosomal abnormalities in the fetus. These abnormalities, such as aneuploidy, occur when the embryo has an abnormal number of chromosomes, often due to random errors during egg or sperm formation. While a single chromosomal issue may be an isolated event, repeated occurrences may prompt genetic testing for both parents to rule out inherited factors.
Another significant category includes anatomical abnormalities of the uterus. Conditions such as uterine septum, fibroids, or intrauterine adhesions can interfere with the implantation or development of an embryo. Hormonal imbalances, including thyroid disorders, polycystic ovary syndrome (PCOS), or luteal phase deficiency, can also contribute to miscarriage risk. Autoimmune issues like antiphospholipid syndrome, a condition that causes blood clotting disorders, have also been linked to pregnancy loss. Additionally, lifestyle factors such as smoking, alcohol use, uncontrolled diabetes, or significant stress may increase risk, though these are often secondary to medical causes.
Diagnosis and Evaluation After Multiple Losses
After two or more miscarriages, thorough evaluation is warranted to identify any potential underlying causes. At May-Grant OB/GYN, we begin with a complete medical history, focusing on previous pregnancies, menstrual patterns, family history, and lifestyle habits. A physical exam and specialized tests are then used to gather more information. These may include blood tests to assess hormone levels, screen for autoimmune conditions, and evaluate clotting factors. Genetic testing, known as karyotyping, may be recommended for both partners to detect chromosomal abnormalities that could affect embryo development.
Imaging studies such as pelvic ultrasound, hysterosalpingography (HSG), or MRI can help visualize the uterus and identify structural issues. In some cases, hysteroscopy—a procedure that allows direct viewing of the uterine cavity—may be used to diagnose or even correct certain abnormalities. The goal of this diagnostic process is not only to find answers but also to provide patients with clarity, validation, and a sense of direction as they consider next steps.
Available Treatment Options
Treatment for recurrent miscarriage is highly individualized and based on the specific cause or combination of contributing factors. For chromosomal abnormalities, preimplantation genetic testing (PGT) during in vitro fertilization (IVF) may help select embryos with the correct number of chromosomes, increasing the chance of a successful pregnancy. If a uterine abnormality is identified, surgical correction can often improve outcomes. For example, a uterine septum can be removed via hysteroscopic surgery, while large fibroids may be treated to restore normal uterine shape and function.
When hormonal imbalances are involved, medications such as progesterone supplements or thyroid hormone replacement may be prescribed to support the early stages of pregnancy. Women diagnosed with antiphospholipid syndrome or clotting disorders may be treated with low-dose aspirin or heparin to improve placental blood flow and reduce miscarriage risk. In cases where no specific cause is identified—a situation known as “unexplained recurrent miscarriage”—empirical treatments such as progesterone support or lifestyle modifications may still improve the likelihood of carrying a pregnancy to term.
Emotional and Psychological Support
The emotional impact of recurrent miscarriage cannot be overstated. It often includes a mix of grief, guilt, frustration, and anxiety, especially during subsequent pregnancies. While physical recovery may happen relatively quickly, emotional healing can take much longer. For many women and couples, the journey includes not just medical treatment but also the need for compassionate psychological support. Counseling, support groups, and therapy can play a crucial role in helping individuals process their experiences and rebuild hope for the future.
At May-Grant OB/GYN, we understand that recurrent miscarriage is not just a clinical issue—it’s a deeply personal one. We work closely with our patients to ensure they feel heard, validated, and supported throughout their care. Whether you’re undergoing testing, treatment, or trying again after loss, our team is here to walk alongside you every step of the way.
Looking Ahead With Confidence
For women who have experienced recurrent miscarriage, the path forward can feel uncertain. However, the outlook is often more hopeful than it seems. With proper evaluation and treatment, the majority of women can go on to have successful pregnancies. According to studies, over 60% of women with unexplained recurrent miscarriage will eventually carry a healthy pregnancy to term, even without targeted interventions. When an underlying cause is identified and treated, the odds can improve even further.
Every woman’s journey is different, and so is her care plan. At May-Grant OB/GYN, we believe in personalized, evidence-based care that takes into account your unique circumstances, health history, and emotional needs. Our goal is to help you move forward not only with medical answers but with confidence, compassion, and a renewed sense of hope.
Sources:
Practice Committee of the American Society for Reproductive Medicine. (2012). Evaluation and Treatment of Recurrent Pregnancy Loss. Fertility and Sterility.
Ford, H. B., & Schust, D. J. (2009). Recurrent Pregnancy Loss: Etiology, Diagnosis, and Therapy. Reviews in Obstetrics & Gynecology.
Christiansen, O. B. (2013). Evidence-Based Investigations and Treatments of Recurrent Pregnancy Loss. Current Opinion in Obstetrics and Gynecology.
