Recurrent Miscarriage: Causes, Tests, and Support After Repeated Loss
Key takeaways
- Recurrent miscarriage is commonly defined as two or more consecutive losses; in the UK, dedicated investigations are usually offered after that point.
- A specific cause is found in only a minority of couples; for many, no clear reason is identified, which is painful but not the same as no hope.
- Investigations can include blood tests for clotting and antiphospholipid syndrome, pelvic ultrasound, and genetic testing, ideally through a recurrent miscarriage clinic.
- Most people who have had repeated losses go on to have a successful pregnancy; support and specialist care matter alongside the medical work-up.
Recurrent miscarriage is commonly defined as the loss of two or more pregnancies, and it is the point at which couples are usually offered dedicated investigations rather than reassurance alone. It is one of the loneliest experiences in fertility, partly because miscarriage is so often talked about as a one-off. Repeated loss is different, and it deserves answers and care.
What counts as recurrent miscarriage
Recurrent miscarriage is most commonly defined as two or more consecutive pregnancy losses. UK guidance from the Royal College of Obstetricians and Gynaecologists supports investigating after two or more miscarriages; some services have historically waited until three, so it is worth asking what threshold your local clinic uses. Miscarriage itself is common, affecting roughly 1 in 5 known pregnancies, but recurrent loss is much less common, and reaching that point is a clear reason to be seen rather than sent away.
After my second loss I was told to “try again and see,” and it took pushing to be referred. If you have had two or more miscarriages, you are entitled to ask the question.
The possible causes
A specific, treatable cause is found in only a minority of couples, and for many people no clear reason is ever identified. That uncertainty is hard, but it is not the same as having no hope. The causes that investigations look for include:
- Antiphospholipid syndrome: an immune and clotting condition that is one of the few clearly treatable causes of recurrent loss.
- Chromosomal factors: a structural rearrangement in one partner’s chromosomes, or chromosomal problems in the pregnancy itself.
- Problems with the shape of the womb (uterine anomalies), which a scan can identify.
- Hormonal and metabolic conditions, including poorly controlled thyroid disease or diabetes.
Age is also a strong factor, because the chance of a chromosomally normal pregnancy falls as we get older. We cover the wider picture in the causes of infertility and in how age affects fertility.
The investigations offered
Investigation after recurrent miscarriage is usually arranged through a specialist clinic rather than as scattered one-off tests. Depending on your history, it can include:
- Blood tests for antiphospholipid antibodies, ideally repeated to confirm a result, plus tests for other clotting problems.
- A pelvic ultrasound to look at the shape and lining of the womb.
- Genetic testing of both partners, and sometimes of the pregnancy tissue after a loss, to look for chromosomal factors.
The aim is to find anything treatable and, just as importantly, to give you a clearer picture so that decisions feel less like guesswork. Even when no cause is found, most people who have had recurrent miscarriage go on to have a successful pregnancy, often with supportive early-pregnancy monitoring and reassurance scans.
Support and looking after yourself
Recurrent miscarriage takes a real emotional toll, and looking after that side is part of the care, not a soft extra. The stress of fertility loss has been compared to that of a serious illness, and grief after repeated miscarriage is layered: each loss carries the weight of the ones before it. Specialist fertility counselling is widely available, and many clinics offer or refer to it. Charities such as Fertility Network UK and the Miscarriage Association run support lines and groups where you can speak to people who understand.
For practical and emotional strategies, see our guide to coping with the emotional side of fertility treatment, and if you are deciding who to tell and how, telling family and friends may help.
One thing I wish someone had said plainly: repeated loss is not your fault, and there is nothing you did to cause it. Hearing that from a specialist, rather than from my own spiralling at 3am, made a difference.
When to seek help
If you have had two or more miscarriages, ask your GP about referral to a recurrent miscarriage or early pregnancy service. Fertility and pregnancy care can be time-sensitive, so do not delay or assume nothing can be done; a clinic can both investigate and support you. If you are bleeding heavily, in severe pain, or feel very unwell during a pregnancy, seek urgent medical care.
This guide is general information and support, not medical advice or a diagnosis. Please consult your GP or a fertility specialist about your own situation.
References
- Recurrent miscarriage, NHS.
- Recurrent and Late Miscarriage: Tests and Treatment of Couples (Green-top Guideline), Royal College of Obstetricians and Gynaecologists (RCOG).
- Recurrent Pregnancy Loss, American Society for Reproductive Medicine (ReproductiveFacts.org).
- Support after miscarriage, Fertility Network UK.
Frequently asked questions
What counts as recurrent miscarriage?
Recurrent miscarriage is commonly defined as the loss of two or more pregnancies. UK guidance from the Royal College of Obstetricians and Gynaecologists supports investigating after two or more losses, while some services have historically used three. If you have had two or more miscarriages, you can ask your GP or fertility team about referral to a recurrent miscarriage clinic.
What causes recurrent miscarriage?
Possible causes include antiphospholipid syndrome (a treatable clotting problem), chromosomal factors in one or both partners, problems with the shape of the womb, and certain hormonal or metabolic conditions. Age is also a strong factor. In a large proportion of couples no single cause is found, which is distressing but does not mean a future pregnancy cannot succeed.
What tests are done for recurrent miscarriage?
Investigations can include blood tests for antiphospholipid antibodies and other clotting problems, a pelvic ultrasound to look at the shape of the womb, and genetic testing of the parents or of pregnancy tissue. The exact tests depend on your history and are usually arranged through a specialist clinic rather than piecemeal.
Can you still have a baby after recurrent miscarriage?
Yes. Most people who experience recurrent miscarriage go on to have a successful pregnancy, even when no specific cause is found. Specialist care, treatment of any identified cause, and supportive early-pregnancy monitoring all help. Your team can give you a more personal picture based on your age and history.
When should I be referred to a specialist?
If you have had two or more miscarriages, it is reasonable to ask your GP about referral to a recurrent miscarriage or early pregnancy service. Do not wait or assume nothing can be done; fertility and pregnancy care can be time-sensitive, and a clinic can both investigate and support you.
Does stress cause recurrent miscarriage?
There is no good evidence that everyday stress or work causes miscarriage, and it is important to say clearly that repeated loss is not your fault. Grief, anxiety, and low mood are common and understandable responses to loss; support and counselling help with the emotional side, even though they are not a cause of it.
Written by Emma Lawson. Medically reviewed by Dr Priya Nair, MBBS, MRCOG.
Our guides are written from personal experience and reviewed by a qualified clinician for accuracy. Read our editorial policy.