Pregnancy Loss Pregnancy Loss Causes and Risk Factors Testing for Causes of Recurrent Miscarriages By Krissi Danielsson Krissi Danielsson Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage. Learn about our editorial process Updated on February 23, 2020 Medically reviewed by Rachel Gurevich, RN Medically reviewed by Rachel Gurevich, RN Facebook LinkedIn Twitter Rachel Gurevich is a fertility advocate, author, and recipient of The Hope Award for Achievement, from Resolve: The National Infertility Association. Learn about our Medical Review Board Print Fuse/Getty Images Table of Contents View All Table of Contents Uterine Tests Blood Tests Other Tests After having a miscarriage, most people want to know why it happened and whether anything could have prevented it. Usually, the cause was a random genetic problem in the developing baby, and nothing could have stopped it. And the majority of people who have one miscarriage go on to have an uneventful next pregnancy. But with two, three, or more miscarriages in a row, the chances are lower that the problem is random chromosomal issues. So at this point, it makes sense to see a doctor to check for potentially treatable causes of multiple miscarriages. There aren't always answers, but about half the time, the tests will reveal why the miscarriages might be happening. Treatment might boost the odds of a successful subsequent pregnancy. Uterine Tests Sometimes problems with the uterus, such as endometriosis or an abnormally shaped uterus, may lead to recurrent miscarriages. Tests that look at problems with the uterus include: Hysterosalpingogram (HSG): A dye is injected into the uterus. An X-ray is taken to look at whether the fallopian tubes are open and for an abnormal shape of the uterus that might cause problems in pregnancy. Hysteroscopy: A thin telescope is inserted into the uterus to view and repair minor problems of the uterus. Transvaginal ultrasound: An ultrasound checks for uterine, ovarian, and endometrial problems that could be contributing to recurrent miscarriages. Endometrial biopsy: A small piece of the endometrium (the lining of the uterus) is removed to help diagnose conditions that interfere with conception or pregnancy. Can an Abnormal Uterus Cause Miscarriage? Blood Tests Blood tests are a non-invasive way to evaluate evidence of underlying health conditions, hormonal imbalances, or gene mutations that could contribute to recurrent miscarriages. Blood might be tested for: Lupus anticoagulant antibodies: One of the markers for antiphospholipid syndrome Anticardiolipin antibodies: Another marker for antiphospholipid syndrome MTHFR gene mutation: This mutation can impair the body's ability to absorb folic acid and may be linked to an increased risk of miscarriages Thrombophilias: PT (prothrombin time), aPTT (activated partial thromboplastin time), protein C, factor V Leiden, protein S deficiency, prothrombin gene mutation, and antithrombin III deficiency can all be linked with recurrent miscarriages Thyroid panel: Hypothyroidism may increase the risk of second-trimester miscarriage (although the evidence is not conclusive) Progesterone: Tested a week after ovulation or on day 21 of a 28-day cycle to check for abnormal levels Other hormones: Especially in people over 35, test for levels of follicle-stimulating hormone (FSH), anti-Mullerian hormone (AMH), and luteinizing hormone (LH) Karyotyping of the parents: Performed on both parents to look for problems in the genetic structure that might raise pregnancy loss risks, such as balanced translocation Fertility Health Quizzes Other Tests Other tests, such as fetal tissue karyotyping, might be done if you had a D&C for your most recent miscarriage. This is a chromosomal test of the tissue to rule out chromosomal abnormalities as a cause of miscarriages. Even though statistics may not be reassuring, studies indicate that the majority of couples who have recurrent miscarriages without a known cause eventually have a successful pregnancy. A Word From Verywell You may have mixed feelings about seeking testing. Recurrent miscarriages can put you in the strange position of actually wanting to find something wrong with you because a diagnosis and potential treatment might make the idea of the next pregnancy seem a little less scary. But, on the other hand, you may feel scared to proceed with testing because you're afraid you won’t find answers. If you feel that way, it’s understandable. However, try to remember that even if you don’t get answers, you should feel some reassurance that at least you can try again, knowing that you do not have a known medical problem to get in the way of your having a successful pregnancy. What Is a Rainbow Baby? 6 Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Hyde KJ, Schust DJ. Genetic considerations in recurrent pregnancy loss. Cold Spring Harb Perspect Med. 2015;5(3):a023119. doi:10.1101/cshperspect.a023119 Garrido-Gimenez C, Alijotas-Reig J. Recurrent miscarriage: causes, evaluation and management. Postgrad Med J. 2015;91(1073):151-62. doi:10.1136/postgradmedj-2014-132672 Dell'edera D, L'episcopia A, Simone F, Lupo MG, Epifania AA, Allegretti A. Methylenetetrahydrofolate reductase gene C677T and A1298C polymorphisms and susceptibility to recurrent pregnancy loss. Biomed Rep. 2018;8(2):172-175. doi:10.3892/br.2018.1039 Sarkar D. Recurrent pregnancy loss in patients with thyroid dysfunction. Indian J Endocrinol Metab. 2012;16(Suppl 2):S350-1. doi:10.4103/2230-8210.104088 Barber JC, Cockwell AE, Grant E, Williams S, Dunn R, Ogilvie CM. Is karyotyping couples experiencing recurrent miscarriage worth the cost?. BJOG. 2010;117(7):885-8. doi:10.1111/j.1471-0528.2010.02566.x Kling C, Magez J, Hedderich J, von Otte S, Kabelitz D. Two-year outcome after recurrent first trimester miscarriages: prognostic value of the past obstetric history. Arch Gynecol Obstet. 2016;293(5):1113-1123. doi:10.1007/s00404-015-4001-x By Krissi Danielsson Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit