Why do recurrent miscarriages occur The most important tests that reveal the cause and prevent recurrence

Have you experienced recurrent miscarriages? Do you feel confused or afraid it might happen again?Recurrent miscarriage is one of the most emotionally challenging experiences for women—especially for those longing to conceive and build a family.The good news is that modern medicine has developed advanced diagnostic tests that can help uncover hidden causes and guide effective treatment.In this article from Dalili Medical, we provide you with a comprehensive and simplified guide to the most important tests for recurrent miscarriage—when they are needed and how to interpret the results.

✅ What is Recurrent Miscarriage?

Recurrent miscarriage, also known as Recurrent Pregnancy Loss (RPL), is defined as two or more consecutive pregnancy losses before the 20th week of gestation.
It requires a thorough medical evaluation—especially if the woman is relatively young and has no known chronic illnesses.

 What Causes Recurrent Miscarriage?

It’s important to understand that miscarriage is not always due to a “weak uterus.” Possible causes include:

• Genetic and chromosomal abnormalities

• Hormonal imbalances

• Immune system disorders

• Blood clotting disorders

• Chronic infections

• Uterine abnormalities (congenital or acquired)

That’s why a comprehensive panel of tests is essential to uncover the real cause.

 Key Tests for Recurrent Miscarriage

1. Karyotype Analysis

• Performed for both partners

• Detects genetic issues such as chromosomal translocations or mutations that can lead to miscarriage

2. Antiphospholipid Antibodies Panel

• Includes: ACA, LA, Anti-Cardiolipin, β2-Glycoprotein I

• Screens for Antiphospholipid Syndrome (APS), a common cause of blood clots in the placenta

3. Thrombophilia Panel

• Assesses clotting tendency

• Includes:

  • Factor V Leiden mutation

  • Prothrombin gene mutation

  • Protein C & Protein S deficiencies

  • Antithrombin III deficiency

  • Homocysteine levels

4. Female Hormone Tests

• TSH & Free T4: Evaluate thyroid function

• Prolactin: High levels can interfere with ovulation

• Progesterone: Confirms adequate luteal phase after ovulation

5. Thyroid Autoantibodies

• Includes: TPOAb and TGAb

• Autoimmune thyroid conditions are linked to increased miscarriage risk

6. TORCH Panel (Hidden Infections)

• Includes testing for: Toxoplasmosis, Rubella, Herpes, and CMV

• Detects chronic infections that may harm the developing fetus

7. Uterine Imaging (2D/3D Ultrasound or Hysterosonography)

• To check for structural issues such as:

  • Uterine septum

  • Fibroids

  • Adhesions (Asherman’s syndrome)

⏱️ When Should You Consider These Tests?

You should consider testing after:

• Two or more consecutive miscarriages

• A family history of recurrent pregnancy loss

• Long-standing infertility with a previous pregnancy loss

• Miscarriage after fetal heartbeat was confirmed

 How to Interpret the Test Results?

✅ Normal results
This doesn’t always mean there’s no issue—some cases remain unexplained (idiopathic).

⚠️ Genetic abnormalities
Consult a genetic counselor. IVF with preimplantation genetic testing (PGT) may be recommended.

✅ Positive antiphospholipid antibodies
Requires treatment with low-dose aspirin + heparin to prevent clot-related miscarriages.

⚠️ Hormonal imbalances
Manage with thyroid medications or progesterone support after ovulation.

❓ Frequently Asked Questions

Can I still get pregnant after recurrent miscarriage?
Yes—over 70% of women go on to have successful pregnancies after proper diagnosis and treatment.

Is one test enough?
No. A comprehensive testing approach is crucial for accurate diagnosis.

Does stress cause miscarriage?
Stress alone is not a direct cause but can be a contributing factor. Managing emotional health is strongly encouraged.

✅ Conclusion

Recurrent miscarriage is not the end of your fertility journey. Thanks to advances in medical diagnostics, it's now possible to identify the underlying cause and receive targeted treatment.
Timely and accurate testing could be the turning point between repeated loss and a successful, healthy pregnancy.

 Dalili Medical Tip:

If you’ve experienced two or more miscarriages, don’t ignore it. See a reproductive health specialist and begin the recommended testing. Early diagnosis brings hope.