Experiencing more than one miscarriage can be emotionally and physically devastating. If you’ve had two or more consecutive pregnancy losses, it’s essential to explore possible underlying causes through targeted testing. The good news? Many causes of recurrent miscarriage are treatable once identified.
In this post, we’ll explore the most commonly recommended tests for recurrent pregnancy loss and how they can help guide a personalized, restorative fertility approach.
What Is Recurrent Miscarriage?
Recurrent miscarriage (RM), also known as recurrent pregnancy loss (RPL), is typically defined as two or more consecutive pregnancy losses before 20 weeks of gestation. It affects about 1%–2% of couples trying to conceive.
While miscarriage is often attributed to chance in isolated cases, repeated losses may signal an underlying medical, genetic, or anatomical issue.
Why Testing Matters
Identifying the root cause of recurrent miscarriage can:
- Improve your chances of a healthy pregnancy
- Prevent unnecessary interventions
- Offer peace of mind through clarity
- Support more targeted and effective treatment strategies
10 Recommended Tests for Recurrent Miscarriages
1. Genetic Testing (Karyotyping)
- Both partners may undergo chromosomal analysis (karyotyping) to detect genetic rearrangements like balanced translocations, which can lead to miscarriage.
- If abnormalities are found, IVF with preimplantation genetic testing (PGT) may be considered.
🧬 About 3–5% of couples with recurrent loss have chromosomal abnormalities.
2. Thyroid Function Tests
- A thyroid that’s underactive (hypothyroidism) or overactive (hyperthyroidism) can interfere with early pregnancy development.
- Testing includes TSH, free T4, and thyroid antibodies (TPOAb, TgAb).
🧪 Even subclinical hypothyroidism can increase miscarriage risk.
3. Progesterone Levels
- Progesterone is crucial for sustaining early pregnancy.
- Testing may involve mid-luteal phase progesterone levels or cycle tracking with fertility awareness methods to assess ovulation and luteal phase health.
4. Anti-Müllerian Hormone (AMH) and Ovarian Reserve Testing
- Low ovarian reserve can lead to poor egg quality, contributing to early losses.
- AMH, FSH, LH, and antral follicle count (via ultrasound) can help assess ovarian health.
5. Uterine Imaging (Ultrasound, HSG, or Sonohysterogram)
- Structural issues like uterine septum, fibroids, polyps, or Asherman’s syndrome can interfere with implantation and pregnancy progression.
🖥️ Up to 15% of women with recurrent miscarriage have uterine abnormalities.
6. Antiphospholipid Antibody Syndrome (APS) Testing
APS is an autoimmune condition that increases blood clotting and is a known cause of recurrent miscarriage. Testing includes:
- Lupus anticoagulant
- Anticardiolipin antibodies
- Beta-2 glycoprotein I antibodies
💉 APS is present in about 5%–15% of women with RPL and is treatable with medications.
7. Blood Clotting and Thrombophilia Panel
Inherited clotting disorders such as:
- Factor V Leiden mutation
- Prothrombin gene mutation
- Protein C, Protein S, and Antithrombin III deficiencies
These can increase the risk of pregnancy complications and losses.
8. Insulin Resistance and Blood Sugar Testing
Conditions like polycystic ovarian syndrome (PCOS) or prediabetes can disrupt hormone balance and increase miscarriage risk. Testing includes:
- Fasting glucose and insulin
- Hemoglobin A1c (HbA1c)
9. Vitamin and Nutrient Levels
- Deficiencies in key nutrients like vitamin D, B12, folate, and homocysteine levels may contribute to poor egg quality, implantation failure, or early loss.
10. Infection Screening
- Certain chronic infections (e.g., chronic endometritis, ureaplasma, mycoplasma) may affect the uterine environment.
- In rare cases, testing for TORCH infections may also be considered.
When to See a Specialist
If you’ve experienced two or more miscarriages, consider consulting a reproductive endocrinologist or a provider trained in restorative reproductive medicine. They can recommend the most appropriate tests based on your individual history and support you with a tailored treatment plan. Also checkout this blog post or more information https://fertility-nest.com/2025/07/15/understanding-restorative-reproductive-medicine-for-fertility/
Final Thoughts
Recurrent miscarriage can feel isolating—but you are not alone, and there are answers. Comprehensive testing can uncover hidden factors contributing to loss, helping you and your care team create a plan that supports your fertility, health, and emotional well-being.
💬 If you’re looking for a more holistic and restorative approach to fertility, consider booking a free discovery call today. https://fertility-nest.com/contact-us/