Experiencing a miscarriage can be emotionally and physically devastating. Whilst many miscarriages occur because of factors beyond anyone’s control, recurrent pregnancy loss may sometimes be associated with underlying conditions that can be identified and, in some cases, treated.
Our Recurrent Miscarriage Profile provides a comprehensive assessment designed to identify factors that may contribute to pregnancy loss and help guide future treatment planning.
The Royal College of Obstetricians and Gynaecologists (RCOG) defines recurrent miscarriage as the loss of three or more pregnancies. However, assessment may be appropriate following fewer losses depending on individual circumstances, maternal age, fertility history and previous treatment.
At Genus Fertility, we welcome patients who have experienced one or more pregnancy losses and believe that investigation should be tailored to the individual rather than relying solely on a numerical definition.
Our Recurrent Miscarriage Profile may include investigations assessing:
Not every patient requires every test. Recommendations are made on an individual basis, taking into account your medical history, previous pregnancy outcomes, and fertility goals.
Your assessment begins with a detailed review of your medical, fertility and pregnancy history.
All investigations and ultrasound examinations can be performed within our clinic, allowing us to provide a coordinated and personalised approach to care.
Following completion of your investigations, your results will be reviewed in detail and explained to you. Where abnormalities are identified, we will discuss the evidence behind any available treatment options and work with you to develop an individualised plan for future pregnancy attempts.
When is recurrent miscarriage profiling recommended?
A recurrent miscarriage profile is a structured assessment designed to identify potential factors that may contribute to pregnancy loss. Depending on your individual circumstances, this may include blood tests, genetic investigations and assessment of the uterine cavity.
Traditionally, recurrent miscarriage has been defined as the loss of three or more pregnancies. However, investigation may be appropriate after fewer losses depending on factors such as maternal age, fertility history, previous treatment and the circumstances of the pregnancy losses.
At Genus Fertility, we believe assessment should be individualised. The decision to investigate is based on your personal history and clinical circumstances rather than a rigid numerical threshold alone.
What if the investigations do not find a cause?
This is one of the most emotionally difficult aspects of recurrent miscarriage: even after a thorough investigation, no identifiable cause is found in more than half of all cases. This is genuinely hard to hear when you are hoping for answers, but it is important to understand what it does and does not mean.
An unexplained result does not mean your losses were random or unavoidable. Most miscarriages, even recurrent ones, are caused by chromosomal errors in the embryo that occur by chance rather than by a persistent underlying condition. The likelihood of this increases with age. For many couples with no identified cause, the prognosis for a successful pregnancy with supportive care in the next attempt is genuinely good. Studies have reported live birth rates of over 70 per cent in subsequent pregnancies for women with unexplained recurrent miscarriage, particularly with supportive monitoring in early pregnancy.
If a cause is found, what treatments are available?
Where investigations identify a factor that may be contributing to recurrent miscarriage, treatment options are often available. The most appropriate approach depends on the underlying cause and your individual circumstances.
Antiphospholipid Syndrome (APS) is one of the most important treatable causes of recurrent miscarriage. Treatment typically involves low-dose aspirin and low-molecular-weight heparin during pregnancy, which have been shown to significantly improve pregnancy outcomes.
Thyroid disorders can usually be managed with medication to optimise thyroid function before and during pregnancy. Where thyroid antibodies are present, treatment recommendations are individualised and based on current evidence and hormone levels.
Some abnormalities of the uterine cavity, including polyps, submucosal fibroids and intrauterine adhesions, may be treated using hysteroscopic surgery. Treatment decisions depend on the nature of the finding and whether it is likely to be contributing to pregnancy loss.
Where a chromosomal rearrangement is identified in one parent, genetic counselling may be recommended. In some situations, IVF with Preimplantation Genetic Testing for Structural Rearrangements (PGT-SR) may be considered to help select chromosomally balanced embryos for transfer.
Unfortunately, not all causes of recurrent miscarriage have a specific treatment, and in some cases, no clear cause is identified despite extensive investigation. However, even when investigations are normal, the results can help guide future care and provide reassurance regarding factors that have been excluded.
Any recommendations will be discussed with you in detail, taking into account your individual history, the available evidence, and your future family-building goals.