Recurrent miscarriage, defined as the loss of two or more pregnancies, affects about 1% of couples trying to conceive. It can be a heart-wrenching experience for couples who are longing to start a family. While the causes of recurrent miscarriage are often unknown, there are many tests that can be done to identify any underlying conditions. In this article, we’ll discuss the most common causes of recurrent miscarriage and the tests that can be run to identify them.

Causes of Recurrent Miscarriage

1. Chromosomal Abnormalities – Chromosomal abnormalities are the most common cause of early miscarriage. It occurs when the chromosomes in the embryo are abnormal, which leads to an early pregnancy loss. While most chromosomal abnormalities happen by chance, some couples carry balanced translocations, which can increase the risk of recurrent miscarriage.
2. Hormonal Imbalances – Hormonal imbalances can cause recurrent miscarriage if they’re not treated correctly. Low levels of thyroid hormone (TSH) and progesterone are two common hormonal imbalances that can cause recurrent miscarriage.
3. Autoimmune Disorders – Autoimmune disorders such as antiphospholipid syndrome, anti-thyroid antibodies, and anti-endometrial antibodies can cause recurrent miscarriage. These disorders occur when the body’s immune system mistakenly attacks its tissues, including the embryo.
4. Infections – Certain infections such as Ureaplasma and Chronic Endometritis (CE) have been linked to recurrent miscarriage. These infections can lead to inflammation in the uterus, which can make it difficult for a pregnancy to implant and thrive.

Tests to Run for Recurrent Miscarriage

1. TSH <2.5 – A TSH test measures the amount of thyroid-stimulating hormone in the blood. If the levels are too high or too low, it can cause hormonal imbalances that can lead to recurrent miscarriage. The optimal range for TSH levels while TTC is less than 2.5.
2. Progesterone Levels – Progesterone is a hormone that is necessary for the uterus to support a pregnancy. Checking progesterone levels seven days past ovulation (with a blood test) can ensure that your body is producing enough progesterone to support a pregnancy.
3. Karyotype Testing – Karyotype testing is a blood test that can identify any chromosomal abnormalities that may increase the risk of recurrent miscarriage. It can also identify if a couple carries balanced translocations.
4. Blood Tests for Autoimmune Disorders – Thrombophilias (Factor 5 Leiden), antiphospholipid antibodies (APA), anticardiolipid antibodies (ACL), antisperm antibodies (ASA), anti-thyroid antibodies (ATA), and anti-endometrial antibodies (AEA) can all be detected with blood tests. Identifying these autoimmune disorders can help manage them and reduce the risk of recurrent miscarriage.
5. Infection Screening – Ureaplasma and Chronic Endometritis (CE) can both be detected with a simple swab or blood test. If an infection is detected, antibiotics can be prescribed to treat it.

Recurrent miscarriage can be a devastating experience. While the reasons behind recurrent miscarriage can be difficult to pinpoint, the tests mentioned above can help identify any underlying issues that may be contributing to the losses. By taking steps to address these issues, couples may be able to reduce the risk of future miscarriages and increase their chances of having a healthy pregnancy. It’s important to seek support from medical professionals and loved ones during this difficult time, as it can be a challenging journey both emotionally and physically. With the right care and attention, however, there is hope for those who are struggling with recurrent miscarriage.