Having one miscarriage can be devastating enough, but having one after another is often a very traumatic experience. The very thought of trying again can feel like an uphill struggle, with many couples already expecting another loss before the pregnancy has begun. Any future pregnancies will be full of hope but also tinged with a high level of anxiety. Investigations into a possible reason for recurrent miscarriage is advisable after the third recurrent miscarriage.
There are many possible causes for recurrent miscarriage, including: genetic and hormonal problems; infection and thrombophilic (blood-clotting) defects; uterine problems and cervical weakness. Unfortunately, even after investigation, it’s not always possible for doctors to identify the cause for recurrent miscarriage. However, most couples who have had recurrent miscarriage have a good chance of having a baby in the future.
Where possible, couples should be referred to a specialist unit dedicated to managing recurrent miscarriage.Often good supportive antenatal care in these circumstances makes a big difference; there is some evidence that attending an early pregnancy unit can reduce the risk of further miscarriages.
Causes of recurrent miscarriage
- Genetic: In a small number of cases, one partner may repeatedly pass on an abnormal chromosome, causing recurrent miscarriage.Both you and your partner should be offered a blood test to check for chromosomal abnormalities (known as karyotyping). If the tests show a problem, you should be referred to a clinical geneticist for further testing.
- Hormonal: In some rare cases an imbalance in pregnancy hormones can lead to conditions such as polycystic ovaries, multiple cysts on a woman’s ovaries caused by high levels of LH (luteinising hormone) and testosterone, which can cause miscarriage. Healthcare professionals can discuss the pros and cons of medical treatment for this.
- Blood clotting disorders: Some blood clotting disorders, such as systemic lupus erythematosus and antiphospholipid syndrome can cause ‘sticky blood’ and recurrent miscarriage. These rare disorders of the immune system affect the flow of blood to the placenta and may cause clots that prevent the placenta from functioning properly, depriving the baby of essential oxygen and nutrients, which may lead to miscarriage. Treatment may involve taking aspirin and/or heparin therapy, which both help to thin the blood (research shows that in women who have recurrent miscarriage, their blood has an increased tendency to clot, blocking the flow of nutrients to the baby).
- Uterine problems: An abnormally shaped womb can increase your risk of recurrent miscarriage and premature birth. There are a number of ways to investigate the shape of the uterus and depending on the findings, surgery may be recommended.
- Cervical weakness: If you are considered at risk of cervical incompetence or cervical weakness, you may be offered a scan or be advised to have stitch or cervical cerclage early in the pregnancy.
Plan of care after recurrent miscarriages
Following recurrent miscarriages, you will usually be offered certain blood tests and a scan to try to identify the problem. Where possible, you will be referred to a specialist unit dedicated to managing recurrent miscarriage. Often, good supportive antenatal care in these circumstances makes a big difference; there is some evidence that attending an early pregnancy unit can reduce the risk of further miscarriages.
Blood tests: Blood tests may be used to check for complications, such as blood clotting disorders; polycystic ovaries and high levels of certain antibodies that can interfere with the pregnancy by affecting the placental blood supply or causing abnormal placental attachment in the womb.
Uterine investigations: An abnormally shaped womb can increase your risk of recurrent miscarriage and premature birth. There are a number of ways to investigate the shape of the uterus and depending on the findings, surgery may be recommended.
Knowing what and what not to say to people after the loss of a baby can be difficult. We have come up with a list to help you better comfort a bereaved loved one.
If you lose your baby after the first 12 weeks of pregnancy, but before 24 weeks, this is known as a late miscarriage.
Miscarriage is by far the biggest cause of pregnancy loss in the UK, and it’s also the least understood.
I have always been someone who believes in everything happens for a reason but when something happens THRICE I can only try to be positive.
At the time we didn't tell many people about our pregnancies because it was too hard to then tell them we were no longer pregnant.
A part of me feels angry with everything and everyone, Why me? It’s not fair, what have my husband and I done to deserve this? Will I ever be able to provide my husband with the child we both so dearly want.
- RCOG (2011) The Investigation and treatment of couples with Recurrent First-Trimester and Second Trimester Miscarriage. Green Top Guideline No 17, London Royal College of Obstetricians and Gynaecologists.
ℹLast reviewed on August 1st, 2016. Next review date August 1st, 2019.
By Emma (not verified) on 12 Mar 2018 - 21:05
Hi there. I have just suffered my 5th consecutive miscarriage in just under 2 years. I am 37 years old and myself and my husband have no children of our own or with other people.
My NHS testing came back without showing any cause of our losses. They have all happened between 5 and 9 weeks. I am starting to believe it may be due to NK cells or another type of immune response. Feeling like I don't know what is next as I realise your chances of a successful pregnancy decrease drastically after 5 miscarriages. Trying to remain positive but wondering at which point to decide enough is enough....
By Midwife @Tommys on 15 Mar 2018 - 12:00
Hi Emma, Thank you for your comment.
We are so sorry to hear about all your losses, we cannot begin to imagine how you must be feeling at this time. If you could email the Tommy's midwives directly, then we can give you further information about our recurrent miscarriage clinics around the UK, you fit the criteria for a referral and if you are willing to travel then we can give you the information about speaking to your GP about a referral if you think this would be an option for you? please email on [email protected]
It is good to remain positive as we can help you get a referral for the next step of your journey. Looking forward to hearing from you, best wishes, Tommy's Midwives x
By Midwife @Tommys on 23 Jan 2018 - 13:00
Thank you for posting. I am incredibly sad to hear of your eighth miscarriage in 3 years I cannot imagine how you and your partner are coping and surviving. I know you must be keenly aware and worried about your age and you asked about whether all research and trials were undertaken on women under the age of 42.
I have looked at the criteria at each Tommy's Research Centre and the only centre that excludes women on age is St Mary's in London. Otherwise if women have suffered from recurrent miscarriage they can be referred to the other centres. I have included the link below.
With love and thinking of you both
By Mrs 42 (not verified) on 22 Jan 2018 - 23:42
Myself and my husband have unfortunately had 3 miscarriages between 9 - 12 weeks(with heartbeats) and 5 miscarriages between 4-6 weeks... All in the last 3 years.
We are under the care of our local recurrent miscarriage clinic but I think a combination of NHS plural my age (42) have meant that my options are limited.
We have had all of the NHS tests but they came back normal so we have unexplained recurrent miscarriage. Our latest loss was on boxing day. I'm beginning to feel like it's hopeless.
My question is, does all research and trials take place on ladies under 42? I know fertility drops off dramatically but getting pregnant is not the problem. It's staying that way.
Sending hugs to all of you who have posted. It's a horrible, sad and lonely thing. It's vital that we do share what's happening so that others can understand that some people live with a horrible invisible grief. X
By Sue (not verified) on 15 Feb 2018 - 11:25
I know exactly how you feel, I’m 44, I suffered one misscarriage, then went on to have a healthy pregnancy... then followed by 4 misscarriages.. going to ask if they will test us to see if there is an underlying problem
By Midwife @Tommys on 15 Feb 2018 - 12:57
Hi Thank you for sharing your comment.
We are so sorry to hear about your miscarriages, this must be a very challenging time for you and your family. We would recommend that you see your GP who may be able to refer you to a recurrent miscarriage clinic and they can test to see if there is a cause as to why this is happening.
If you need any help, advice or support then please contact the Tommy's midwives on 0800 0147 800 9am-5pm or please email us on [email protected] We are always here if you need anything and can give your further advice if you need it. Take Care, Tommy's Midwives x
By spyloadedng (not verified) on 30 Dec 2017 - 07:09
thanks for this topic
By Vicki Coe (not verified) on 18 Dec 2017 - 16:40
Hi, I m 42 and had my 4th Miscarriage in September this year. The first was in 2001. I had one last year and two this year!
I have just come home from the recurrent miscarriage clinic at the London hospital.
I had to have blood tests today and need to go back in March.
The doctor I saw said he is sending me for another scan, I have to wait for letter with appointment.
I have Fibroids and they need to determine what kind of Fibroids I have.
Me and my partner would really like a baby of our own. We both have children with exes.
I am really scared about falling pregnant again as we would be devastated if we lost another baby.
What are the chances of having another miscarriage no one knows.
By Midwife @Tommys on 20 Dec 2017 - 10:15
Thank you for your comment. I am sorry for what you and your partner are going through. You are under a specialist team now and i am sure that they will continue to do all they can for you.
Please feel free to contact us on our helpline to discuss further.
0800 0147 800
By Yasmin (not verified) on 27 Nov 2017 - 20:38
Hi my daughter just went on her 3rd miss we were devastated but waiting on blood results to confirm ad me being rhnegative mom des a chance ky dauter is also ad may need a dose of anti rhogam so fingers cross if it's to do wid blood group or wat so u all hang in der leave no stones in turned investigate wez da problems ar before trying to conceive lots if information on internet I learnt a lot from here plz go chek ad good luck to all ad god bless
By Midwife @Tommys on 28 Nov 2017 - 15:15
Thank you for your comment. I am so sorry to hear about your daughter having 3 miscarriages. She may wish to be referred to her local Recurrent Miscarriage unit for more tests to find out why she has had so many -checking her blood group to see if she has any unusual antibodies will be one of these tests.
I have attached 2 links with more information that you and your daughter may find helpful
By Shabby (not verified) on 19 Jan 2017 - 19:52
Myself and my beautiful wife, besides to start a family shortly after we got married (Aug 15)
As we are in a same-sex relationship, we decided to go for IUI treatment, less intrusive and a slight more natural process.. If you can call it that?!
After blood tests, scans and counselling we were ready to start the process. In April 2016, we headed abroad for our first treatment. We have the treatment and hated every minute of the 2 week wait.
Finally, 2 weeks were over and we tested ........... pregnant! Wow who would have thought it, no medication, a fancy turkey baster technique. 5 weeks along, everything was going so well, amazingly actually!
A week later, everything went from amazing to devistating! We lost the pregnancy very early. "Do worry, it is a one off" they told us. Happens to 1 in 4.
Advised to wait and saving pennies, we aheaded off again to have our second insemination- again the dreaded 2 week wait. Finally the day arrived, we tested, yet again pregnant!
Fast forward- 10 weeks my wife had been bleeding, we were told "it's normal" we knew it wasn't. We have an early scan and saw a heartbeat, wow! Supposedly, I had seen, once there is a heartbeat and risk of mc is reduced. After begging for a scan at 10 week , we see clearly, our pregnancy was no long viable.
My wife planned to have the fetous removed sergically, but that night the heavy bleeding began and so did my heart.
We headed off two months later, again, without a medical cycle, again another two weeks, but this time something unexpected happened- we got a neg result- what a kick in the teeth we wasn't successful, we didn't get over the first hurdle!
The following month, we jumped on the plan and this was our last shot, with everything crossed, we undertook the last treatment. My this time, we are £10k down and nothing to show for it.
We enjoyed the city while we were there and tried our best to relax. The two week wait wasn't so bad at all. I had a lot going on. My fathering-in-laws 60th, my grandmother in hospital and my wife already knew she was pregnant, very early on. We didn't need to test.
Then the dreaded blood make an appearance- it wasn't fresh, which is a look sign, so we have been told. Two days later we have a scan "a strong heartbeat" the sonographer said. "Stop worrying, blood isn't always a bad sign" well in our case blood, whatever it's colour, Is not good news!
Sadly my wife had another missed miscarriage and it due to have surgical intervention, the same day I am burying my grandmother.
This have been emotional tourcher and I don't feel I am able to support my beautiful wife the way I should.
By Midwife @Tommys on 20 Jan 2017 - 10:25
I am so sorry to hear about the journey you and your wife are going through and the miscarriages you have been through. For you to write your story shows such courage, I cannot being to imagine what you are going through. Please know that we are here to support to you both. If you would like a chat or a listening ear, here we have a phone line 0800 0147 800 and email [email protected] It is confidential, Monday to Friday 9-5pm service x
By Anonymous (not verified) on 20 Jun 2016 - 21:00
I also too have 1 tube left after an ectopic. I have a son who is 5 so I know I can carry. I have recently had my 5th miscarriage and everytime there is a different issue... Had all the blood tests and biopsy done on me to find nothing wrong. The only thing I have not yet tried is the NK killer cells test which I will have to pay for privately.. £350!! Fingers crossed for both of us. I'm 36 and not getting any younger. I'm
Determined not to give up. Good luck honey x
By Anonymous (not verified) on 18 Jun 2016 - 00:50
I have had 10 miscarriages and one ectopic pregnancy that ended in me losing my right fallopian tube after that followed a million different blood test and a patentce test we find out that after all those test and my husband had genetic blood test done to they say they dont know why this keeps happening so some times u never find out why but the trick is to keep faith that when its supposed to happen it will my left side is patent and after all that loss and believe me ladies it never gets better but i will still get out of bed everyday and get dressed and go on with my life and have faith that it will happen someday it had always been taboo to talk about miscarriage but im here to say all my babies matter and we need to speak out woman need support especially with something like this there was times i wanted to just die and get it over with im no longer at that point but i still have my good and bad days my whole point is that if u have had a miscarriage or multiple plz dont let it eat u inside speak out and speak up vent get it out do not hold all that hurt in it can be very hard to even feel like u can talk about it because some ppl may make u feel like theres something wrong with u but theres not most of the time im not saying theres never a reason for recurring miscarriage but as in my case theres no reason they can find so just keep the faith and stay strong .......wow that was a novel lol
By Anonymous (not verified) on 29 Jun 2017 - 01:53
Me too been through the same situation it's very hard ,but we have to stand strong and knock on Dcs doors till a right oneopens for us,
By Midwife @Tommys on 29 Jun 2017 - 14:51
Hi Thank you for sharing your comment. If you need any help, advice or support then please contact the Tommy's midwives on 0800 0147 800 9am-5pm or please email us on [email protected] We are always here if you need anything and look forward to hearing from you. Best Wishes Tommy's Midwives x