Gynecology

Recurrent Miscarriage: Why It Happens and What Can Actually Be Done

You Deserve More Than “Just Try Again”

If you’ve had two or more miscarriages, you’ve likely been told — by well-meaning people and sometimes even doctors — that it’s “just bad luck” and to “keep trying.” And while it’s true that chromosomal errors in individual embryos are common and largely random, recurrent pregnancy loss is a different situation that deserves real investigation.

In about half of couples with recurrent miscarriage, we find a specific, treatable cause. In the other half, the cause remains unclear — but even these couples have a good chance of success with appropriate support and monitoring.

You deserve a proper answer, not a brush-off.

How Common Is This?

Recurrent miscarriage (defined as 2 or more losses) affects approximately 1–2% of couples. After 3 losses, a cause is found in around 50% of cases. The important thing to know: finding and treating these causes significantly improves the next pregnancy’s outcome.

The Main Causes — and What We Do About Them

Chromosomal Errors in Embryos

The most common cause overall — especially in women over 35. As eggs age, the risk of chromosomal errors increases. These embryos typically stop developing very early.

Solution: IVF with preimplantation genetic testing (PGT-A) allows us to check embryos for chromosomal normality before transfer — so only chromosomally normal embryos are transferred.

Uterine Abnormalities

A uterine septum, submucous fibroids, polyps, or adhesions inside the uterine cavity can prevent normal implantation or lead to early pregnancy loss. Diagnosed with hysteroscopy and often corrected in the same procedure.

Antiphospholipid Syndrome (APS)

An autoimmune condition where specific antibodies cause blood clots in the placental blood vessels, cutting off blood supply to the pregnancy. Diagnosed with blood tests. Treated with low-dose aspirin and heparin during pregnancy — with excellent outcomes. This is one of the most rewarding treatments in recurrent miscarriage management because it works so well.

Thyroid Disease

Even mildly elevated TSH significantly increases miscarriage risk. Often overlooked. Easy to treat. I test every recurrent miscarriage patient.

Sperm DNA Fragmentation

Normal semen analysis doesn’t rule this out. High levels of DNA damage in sperm can cause early embryo arrest and recurrent miscarriage. Requires a specific test — DNA Fragmentation Index (DFI). Treatable with antioxidant therapy, lifestyle changes, or IVF with ICSI using testicular sperm.

The Investigations I Recommend

  • Karyotyping of both partners (chromosomal analysis)
  • Hysteroscopy (uterine cavity assessment)
  • Antiphospholipid antibodies panel
  • Full thyroid panel including antibodies
  • Sperm DNA fragmentation test
  • Blood sugar and other hormonal tests

The Outcome Is Better Than You Think

With appropriate investigation and treatment, over 70% of couples with recurrent miscarriage go on to have a successful pregnancy. That’s a meaningful statistic — and it starts with refusing to accept “just try again” as an answer.

At Punit Fertility, Kandivali Mumbai, we take recurrent pregnancy loss seriously and provide a thorough, compassionate workup.

👉 Book a recurrent miscarriage consultation at Punit Fertility

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