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Miscarriages can occur at any stage of pregnancy, including before a heartbeat is detected, after a heartbeat has been confirmed on ultrasound, or later in pregnancy. Recurrent miscarriage, also called recurrent pregnancy loss, generally refers to experiencing two or more pregnancy losses.
The term miscarriage can be misleading, as it may unintentionally suggest that a woman has failed or somehow contributed to the loss. For this reason, many healthcare professionals prefer the term pregnancy loss, which more accurately reflects the reality that these events are rarely caused by anything the patient did or did not do.
While a single miscarriage is unfortunately common, recurrent miscarriage affects a smaller proportion of people trying to conceive. Understandably, repeated loss often leads people to ask:
These are important and valid questions.
In many cases, there is no obvious cause. However, medical research has identified that with most miscarriages, more than 2 out of 3 are due to a genetic issue in the pregnancy.
Common causes and contributing factors can include:
Many early miscarriages occur because an embryo has developed with chromosomal differences that prevent normal development. This is usually not related to something 1 parent is carrying.
In some cases, one partner may carry a balanced chromosomal rearrangement, which can increase the risk of miscarriage.
Conditions that affect ovulation and hormone balance may play a role, including:
Optimising overall medical, reproductive and metabolic health can often improve pregnancy outcomes.
Certain uterine conditions may increase miscarriage risk, including:
These may be identified through ultrasound or specialised imaging.
Some autoimmune or clotting disorders, such as antiphospholipid syndrome, are associated with recurrent miscarriage and may require targeted treatment during fertility treatment or pregnancy.
Maternal age and in some cases paternal age can influence egg quality and embryo development. As age increases, the likelihood of chromosomal abnormalities within embryos also rises.
Sperm quality may also contribute to embryo development and pregnancy outcomes, which is why fertility assessment should involve both partners where appropriate.
Many people are told to “keep trying,” but recurrent miscarriage deserves thoughtful medical assessment and emotional support.
It may be appropriate to seek specialist advice if you have experienced:
Early assessment can help identify treatable factors, provide reassurance where appropriate, and create a clearer pathway moving forward.
Investigations are tailored to the individual and their medical history, but may include:
Importantly, not every test is necessary for every patient. A balanced, evidence-based approach is essential.
One of the most common misconceptions surrounding recurrent miscarriage is that IVF is the only pathway forward. In reality, treatment depends entirely on the underlying cause; and for many people, IVF may not be necessary.
As a fertility specialist and gynaecologist, Dr Rachael Knight can help identify whether there are medical, hormonal, structural or fertility-related factors contributing to recurrent pregnancy loss and create an individualised treatment plan based on your circumstances and goals.
Importantly, recurrent miscarriage care is not simply about “trying again.” It is about understanding the possible contributing factors, supporting physical and emotional wellbeing, and improving the chances of a healthy ongoing pregnancy where possible.
Depending on the underlying cause, management options may include:
For some patients, improving overall reproductive health and carefully monitoring early pregnancy may be all that is required.
IVF may be recommended in selected situations, particularly where there are additional fertility challenges or repeat or recurrent miscarriage.
Examples may include:
IVF is often combined with preimplantation genetic testing (PGT) to help assess embryos for chromosomal abnormalities before transfer. This treatment has been shown to reduce the risk of miscarriage for most people.
Miscarriage is not only a medical experience, it is also an emotional one.
Grief after pregnancy loss can affect mental health, relationships, confidence and future pregnancy experiences. Many people describe feeling isolated, anxious or unsupported, particularly when miscarriage is minimised by others (especially healthcare providers).
There is no “correct” way to respond to pregnancy loss. Some people wish to try again quickly, while others need time to recover physically and emotionally.
Support matters. Compassionate care should acknowledge both the medical and emotional realities of miscarriage.
Experiencing any pregnancy loss including recurrent miscarriage can feel overwhelming, but you do not need to navigate it alone.
As a Melbourne fertility specialist, Dr Rachael Knight provides evidence-based assessment and personalised care for patients experiencing miscarriage and fertility concerns.
Her approach focuses on:
Seeking answers and support after recurrent miscarriage is not overreacting. It is an important step towards understanding your reproductive health and future pregnancy care.
