Testing for Causes of Recurrent Miscarriages

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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 there was nothing that could have prevented it. And as you probably know, 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. 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 a reason why the miscarriages might be happening. Treatment might boost the odds of a successful subsequent pregnancy.

The field of recurrent miscarriage treatment is fraught with controversy — the jury is still out on some possible miscarriage causes, and many common treatments for recurrent miscarriages are not proven to work.

What follows is a list of the most common tests that doctors use for people with recurrent miscarriages. The exact tests that your practitioner runs may be different from this list.

Uterine Tests

Sometimes problems with the uterus may lead to recurrent miscarriages. Endometriosis or an abnormally shaped uterus are a couple of examples of uterine problems that could contribute to recurrent misscariages.

Tests that look at problems with the uterus inlcude:

  • Hysterosalpingogram (HSG): A dye is injected into the uterus and an X-ray is taken to look at whether the fallopian tubes are open, as well as 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 that 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 may be interfering with conception or pregnancy.

Blood Tests

Blood tests are a non-invasive way to determine if there may be evidence of underlying health conditions, hormonal imbalances, or gene mutations that may be contributing to recurrent miscarriages.

Some blood tests include:

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 in order to rule out chromosomal abnormalities as a cause of the miscarriages.

Even though statistics may not be reassuring, studies indicate that 70% of couples who have recurrent miscarriages without a known cause do eventually go on to 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 putting a name to the problem and having a potential treatment might make the idea of the next pregnancy seem a little less scary. Some women even feel scared to proceed with testing because they’re afraid they won’t find answers.

If you feel that way, it’s understandable. 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.

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  5. 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

  6. Brigham SA, Conlon C, Farquharson RG. A longitudinal study of pregnancy outcome following idiopathic recurrent miscarriage. Hum Reprod. 1999;14(11):2868-71. doi:10.1093/humrep/14.11.2868

Additional Reading
  • American College of Obstetricians and Gynecologists (ACOG), "Management of recurrent early pregnancy loss." Feb. 2001. ACOG
  • Brigham, S.A., C. Conlon, and R.G. Farquharson, “A longitudinal study of pregnancy outcome following an idiopathic recurrent miscarriage.” Nov. 1999. Human Reproduction 14:2868-2871.
  • Johnson, Kate. "Recurrent miscarriage tied to insulin resistance: Check fasting insulin levels." OB/GYN News 15 Jan 2002.