Recurrent Miscarriage: Causes, Testing, and Treatment

Losing one pregnancy is heartbreaking. Losing two or three in a row can feel unbearable — and it often comes with a painful, unanswered question: why does this keep happening to us? If this is where you are right now, we want you to know two things. First, you are not alone — around 1 in 100 couples trying for a baby experience recurrent miscarriage. Second, and most importantly: the odds are still strongly in your favour.

In this guide, the fertility specialists at Myra IVF Centre in Kenya, led by Dr. Sarita Sukhija, explain what recurrent miscarriage really is, the causes we look for, the tests every couple should have, and the treatments — from simple medication to IVF with genetic testing of embryos — that turn repeated loss into a healthy pregnancy.

What Is Recurrent Miscarriage?

Recurrent miscarriage — also called recurrent pregnancy loss (RPL) — is defined as the loss of two or more pregnancies before viability. Older textbooks required three losses before investigating, but modern guidelines (and our own practice at Myra IVF Centre) recommend a full work-up after two consecutive miscarriages, particularly when the woman is 35 or older, because every month matters.

Some perspective helps here. A single miscarriage is very common — it happens in roughly 15–20% of recognised pregnancies, usually because of a random chromosomal error in that particular embryo. It says almost nothing about your future chances. Recurrent miscarriage is different: when losses repeat, the chance that an underlying, fixable cause is at work rises — and that is exactly what testing is designed to find.

What Causes Recurrent Miscarriage?

Recurrent pregnancy loss rarely has one universal explanation. These are the main categories we investigate:

Cause	What happens	How common
Chromosomal (embryo)	Random errors in the embryo's chromosomes stop development; risk rises sharply with maternal age	50–60% of early losses
Parental chromosome rearrangement	One partner carries a balanced translocation that repeatedly produces abnormal embryos	2–5% of couples with RPL
Uterine (anatomical)	Septum, submucosal fibroids, polyps or adhesions interfere with implantation and placenta growth	10–15% of couples
Antiphospholipid syndrome (APS)	Autoimmune antibodies cause tiny clots in the placenta, cutting off the pregnancy's blood supply	5–15% of couples
Hormonal / metabolic	Uncontrolled thyroid disease, poorly controlled diabetes, high prolactin, and PCOS-related factors	8–12% of couples
Male factor	High sperm DNA fragmentation is increasingly linked to repeated pregnancy loss	Emerging evidence
Unexplained	All tests come back normal — frustrating, but carries the best prognosis of all groups	Up to 50% of couples

Notice what is not on this list: normal exercise, working, lifting your toddler, stress, arguments and intimacy. None of these cause miscarriage — and letting go of self-blame is a genuine part of treatment.

Testing: The Work-Up Every Couple Deserves

A proper recurrent miscarriage work-up is systematic, not random. At Myra IVF Centre it includes:

• Karyotype (chromosome) testing of both partners — a blood test to detect balanced translocations and other rearrangements.
• Genetic testing of miscarriage tissue — where available, testing the products of conception tells us whether that loss was chromosomal, which powerfully guides next steps.
• Pelvic ultrasound — a detailed scan (often 3D) to assess the shape of the uterine cavity and detect fibroids, polyps and ovarian issues.
• Hysteroscopy — a thin camera examines the inside of the uterus directly, and can treat septa, polyps and adhesions in the same sitting.
• Antiphospholipid antibody screen — blood tests for lupus anticoagulant, anticardiolipin and anti-β2-glycoprotein antibodies, repeated 12 weeks apart to confirm.
• Hormonal and metabolic screen — TSH (thyroid), prolactin and HbA1c (blood sugar). Thyroid problems are common and very fixable — see our guide on managing thyroid in pregnancy.
• Semen analysis ± sperm DNA fragmentation — the male side matters too; see our guide to male infertility.
• Ovarian reserve testing (AMH) — not a cause of miscarriage itself, but essential for planning treatment, especially over 35 (see low AMH and poor ovarian reserve).

Treatment: Matching the Solution to the Cause

This is where testing pays off — because most identified causes have a specific, proven treatment:

Cause found	Treatment
Antiphospholipid syndrome	Low-dose aspirin + heparin injections in pregnancy — live birth rates rise to around 70–80%
Uterine septum, polyps, adhesions	Hysteroscopic surgery — a minor day-case procedure that restores a normal cavity
Submucosal fibroids	Hysteroscopic or laparoscopic removal depending on size and position
Thyroid disease, diabetes, high prolactin	Medication to normalise levels before conceiving again — simple and highly effective
Parental translocation / repeated chromosomal losses	IVF with PGT — embryos are screened and only chromosomally normal ones transferred
High sperm DNA fragmentation	Lifestyle changes, antioxidants, treating varicocele; ICSI with sperm selection in resistant cases
Unexplained	Supportive care, early pregnancy monitoring, progesterone support where indicated — with 60–70% success in the next pregnancy

When Does IVF with Genetic Testing (PGT) Make Sense?

IVF is not the automatic answer to recurrent miscarriage — but in specific situations it changes the game:

• A balanced translocation in either partner: PGT identifies the embryos that inherited a normal chromosome set, dramatically cutting the miscarriage rate per transfer.
• Repeatedly chromosomal losses: when miscarriage tissue keeps showing aneuploidy — especially over 35 — screening embryos before transfer avoids transferring the embryos destined to be lost.
• Recurrent loss combined with infertility: when it is also taking a long time to conceive at all, IVF addresses both problems at once.

PGT does not create good embryos — it selects them. That honest distinction matters, and it is exactly the kind of straight answer you will get in a consultation with our team. If you have also experienced failed IVF cycles, our guide to IVF failure and what to do next covers the overlapping territory.

The Emotional Side: Grief Is Part of the Diagnosis

Recurrent miscarriage is not just a medical problem — it is repeated bereavement, often grieved silently. Anxiety in the next pregnancy is almost universal. We encourage every couple to:

• Take time to grieve each loss — it was a real pregnancy and a real hope.
• Seek counselling support; it measurably improves wellbeing and helps couples stay united rather than divided by loss.
• Ask for early reassurance scans in the next pregnancy — frequent monitoring in the first trimester reduces anxiety and is associated with better outcomes in unexplained RPL ("tender loving care" protocols).

Recurrent Miscarriage Care at Myra IVF Centre, Kenya

At Myra IVF Centre, couples with recurrent pregnancy loss receive complete, joined-up care:

• Full RPL work-up under one roof — chromosomal, anatomical, hormonal, immune and male-factor testing.
• Hysteroscopic and laparoscopic surgery for uterine causes, performed by experienced surgeons.
• IVF with PGT in our ISO 9001 certified laboratory when genetic screening of embryos is the right tool.
• Structured early-pregnancy monitoring for every RPL patient who conceives — you are never left to "wait and see" alone.
• Three convenient locations — Nairobi, Mombasa and Kisumu.

With over 15 years of experience and a 79% overall IVF success rate, our team led by Dr. Sarita Sukhija has guided many couples from repeated loss to a healthy baby.

Conclusion

Recurrent miscarriage is devastating — but it is also one of the most hopeful diagnoses in fertility medicine. A structured work-up finds a treatable cause in about half of couples, and even when every test is normal, most women go on to deliver a healthy baby. The keys are simple: investigate after two losses (or one, if you are over 35), treat the specific cause rather than guessing, and get supported early monitoring in the next pregnancy.

If you have experienced repeated pregnancy loss, please don't keep trying in the dark. Speak with our fertility specialists at Myra IVF Centre — answers exist, and so does a plan.

Book a consultation today. Contact us at +254 786656236 or drsarita2007@gmail.com.