Having even a single miscarriage is devastating. Experiencing multiple (recurrent) miscarriages can feel unfathomable.
It is also a sign that something is preventing the development of a healthy fetus, and there are things we can do to support you as we find out “why.”
3 Steps to Take After Multiple Miscarriages
1. Get the emotional support you need and deserve
First and foremost, we encourage you to get the emotional support you need. Our culture doesn’t do the best job at honoring the toll miscarriages take on women, their partners, and any siblings. The experience becomes two deaths in one – the death of the baby you cherished and the death of the dream lives you envisioned for yourselves.
Repeat miscarriage can indicate an infertility issue (more on that next), so we recommend reaching out to an infertility counselor. Even if you don’t have an infertility diagnosis, infertility counselors are well-versed in the grief work and support that women need when they’ve experienced multiple losses as you have. Online and in-person miscarriage or grief support groups can also be immensely helpful so you don’t feel so alone and can connect with people who “speak your language,” literally and metaphorically.
2. Schedule an infertility appointment with your OB/GYN
Miscarriages are almost always an indication of:
- Chromosomal abnormality
- Genetic abnormality
- The body’s inability to develop and carry a full-term fetus
While miscarriages are very common (about 25% of all pregnancies), recurrent miscarriages are defined as two or more miscarriages in a row. After three, repeat miscarriages (recurrent pregnancy loss), the American College of Obstetrics and Gynecology (ACOG) recommends infertility testing.
We want to be clear that chromosomal and genetic abnormalities do not necessarily indicate that you or your partner are carrying them. The fertilization process and rapid cell division that leads to the development of a healthy baby is incredibly complicated. There are an infinite number of places where a little something going wrong leads to the miscarriage of the embryo or fetus.
However, when this happens three or more times in succession, it feels more like a specific cause than random chance, and that’s when we recommend infertility testing.
Your gynecologist will order a range of tests, from preconception genetic testing (in case you or your partner are carrying chromosomal/genetic abnormalities you don’t know about)
- We’ll talk to you about your age and reasonable fertility timelines (if you are 35+ s/he might refer you ASAP to a fertility specialist since time is of the essence)
- If you experience your first or second miscarriage, we’ll encourage you to be prepared to collect a sample of any future miscarriage. While it is traumatic – we know and understand!) – testing miscarriage tissue can provide clear and identifiable information about why you’re miscarrying.
- A thorough review of prior prenatal tests/imaging in case something wasn’t clearly identifiable
- Thorough review of past reproductive/medical history
- Establish whether there may be an undiagnosed or unaddressed reproductive issue such as endometriosis, fibroid tumors, diabetes or other medical conditions, obesity, etc.
- Review of your current medications and supplements
- Hormone tests
- Testing of your ovarian reserves
- Ultrasound and other tests that look for uterine abnormalities
- Recommendation for sperm analysis (we can’t test for egg quality yet, but sperm quality can impact miscarriage if there are abnormalities)
Click here to read more about basic fertility tests.
3) Referral to an infertility specialist
If we cannot quickly establish the most probable cause for your recurrent miscarriages, we’ll refer you to a fertility specialist. Visit, 9 Signs You Should Consider Infertility Testing, to learn more.
As referenced above, women who are 35-years or older and who’ve had multiple miscarriages might get the automatic pass to the specialist track. Miscarriages are more common in your age bracket, and egg quality and quantity begin to decline rapidly after age 36.
While gynecologists are trained to provide expert overviews of the most common causes of infertility, we defer to endocrinologists and fertility specialists when there are missing links or any unsolved mysteries. They are the ones who have the expertise identifying infertility factors and getting you on a personalized fertility treatment plan.
Once you’re pregnant again, we’ll be happy to welcome you back to the Overlake fold. Contact our office to schedule an appointment to determine the best next steps for you.