Most doctors consider evaluation after two miscarriages in a row, since that pattern is uncommon enough to look into. Recurrent pregnancy loss means two or more pregnancy losses, and fewer than 5 in 100 women have two miscarriages back to back. A thorough physical exam and testing are generally recommended once that happens, so a clinician can look for a possible cause while keeping in mind that many people never get a clear answer.
Medical Disclaimer: This page is for general education only. It is not medical advice, diagnosis, or treatment, and reading it does not create a provider-patient relationship. Talk with a licensed healthcare provider about your specific situation. If you are having a medical emergency, call 911 or go to the nearest emergency room. See our full Medical Disclaimer.
Reviewed by the RHC Health Desk. Last verified: August 26, 2026.
Seek Care Right Away If You Notice These Signs
If you are currently pregnant and have any of the following, contact your provider or seek emergency care immediately, including calling 911 if symptoms are severe: heavy vaginal bleeding that soaks through a pad every hour, severe or worsening abdominal or pelvic pain, fever, dizziness or fainting, or passing tissue along with heavy bleeding. These signs need prompt medical attention regardless of your pregnancy-loss history.
It Is Not Your Fault
It’s common to wonder whether something you did caused a miscarriage. According to the American College of Obstetricians and Gynecologists (ACOG), miscarriages are almost never linked to anything a person did or did not do. About half of all miscarriages happen because an embryo randomly receives an abnormal number of chromosomes during fertilization — a chance event, not the result of a specific medical condition or a lifestyle choice.
What Can Cause Recurrent Pregnancy Loss
In more than half of women with repeated miscarriages, no cause is ever found. When a cause is identified, ACOG points to a few general categories:
- Chromosome problems: A random chromosome error in the embryo is the most common reason for any single miscarriage, and the chance of this increases with age. In a smaller number of couples, one partner carries a “translocation,” where part of one chromosome has moved to another. People with a translocation usually have no symptoms themselves, but some of their eggs or sperm carry an abnormal amount of genetic material.
- Uterine conditions: Structural issues such as a septate uterus (a wall of tissue partly dividing the uterus), Asherman syndrome (scarring inside the uterus), or fibroids and polyps can be linked to pregnancy loss.
- Antiphospholipid syndrome (APS): This autoimmune clotting disorder can contribute to pregnancy loss and can occur alone or alongside other autoimmune conditions.
- Diabetes mellitus: Poorly controlled blood sugar can raise the risk; keeping levels in a normal range before and during pregnancy may lower it.
- Thyroid disease: Untreated thyroid problems can increase miscarriage risk, and treatment may reduce it.
The National Institute of Child Health and Human Development (NICHD) adds that pregnancy loss before 20 weeks in general can also be linked to maternal health issues, infections, and environmental exposures — though, as with recurrent loss specifically, a clear cause often isn’t found.
What Testing May Include
There is no single required test. According to ACOG, a clinician typically builds an evaluation around your history and exam findings, which may include:
- A detailed review of your medical history and past pregnancies.
- A complete physical exam, including a pelvic exam.
- Blood tests to check for immune system-related problems, such as antiphospholipid syndrome.
- Genetic testing to look for a possible chromosomal cause, such as a translocation.
- Imaging tests to check for a uterine structural problem.
NICHD notes that, more broadly, diagnosing pregnancy loss can involve blood tests, ultrasound, and a pelvic exam — the specific combination depends on timing and individual circumstances, which is why this list describes categories of testing rather than a fixed protocol for any one person.
What to check before acting on Recurrent Pregnancy Loss
- Write down the approximate timing and any symptoms of each pregnancy loss, if you remember them.
- Ask your provider which tests they recommend for your specific history, and why.
- Ask what a positive or negative result on each test would mean for next steps.
- Ask whether a support resource or counselor is available if you want help with the emotional side of this process.
- Bring a partner’s medical history if relevant, since some causes involve both partners.
If a Cause Is Found — and If It Isn’t
ACOG explains that when a specific cause is identified, treatment is generally aimed at that cause. Examples include genetic counseling and options like preimplantation genetic testing during IVF for a chromosome translocation, corrective surgery for a structural problem such as a uterine septum, or blood-thinning medication for a clotting-related condition like APS. Any decision about starting, stopping, or changing a treatment should be made with a qualified clinician who knows your full history — this page cannot tell you which option, if any, fits your situation.
Even when no cause is found, the outlook is often good: ACOG reports that about 65 in 100 women with unexplained recurrent pregnancy loss go on to have a successful next pregnancy without special treatment.
Comparing Paths After Recurrent Pregnancy Loss
- Cause identified (genetic): May involve genetic counseling, and options such as IVF with preimplantation genetic testing, donor eggs, or donor sperm with IUI, depending on the specific finding.
- Cause identified (uterine structural): May involve corrective surgery, such as removing a uterine septum.
- Cause identified (clotting-related, e.g. APS): May involve blood-thinning medication such as heparin, sometimes with low-dose aspirin, prescribed and monitored by a clinician.
- No cause identified: No specific treatment may be needed; ACOG reports a majority of these women go on to have a successful pregnancy.
Which path applies to you depends entirely on your own evaluation results and your provider’s judgment — this comparison is for orientation only, not a way to predict or choose your own outcome.
Grief, Support, and Trying Again
Grief after a pregnancy loss is normal, and it can take longer to resolve than the physical recovery, which usually takes a few hours to a couple of days. Partners may grieve differently or express it less visibly. ACOG suggests talking with an ob-gyn or therapist if either partner is struggling, and reaching out to trusted people for support.
Physically, it’s possible to ovulate and become pregnant as soon as about two weeks after an early miscarriage, but the right timing for you is a conversation to have with your ob-gyn. Some people choose to try again quickly; others take more time, or decide not to try again — ACOG is clear that there is no universally right choice.
Where current knowledge about Recurrent Pregnancy Loss stops
People with a known autoimmune condition, thyroid disease, diabetes, or a known uterine structural issue may need closer or earlier evaluation — this is a conversation for your provider, not something this page can determine for you. This article describes general categories of causes and testing based on ACOG and NICHD guidance; it doesn’t cover every possible test, every rare cause, or personal risk factors. It also doesn’t address cost, insurance coverage, or how quickly you should schedule an evaluation in your specific case, since those vary by provider, plan, and individual history.
Reader questions on Recurrent Pregnancy Loss
How many miscarriages count as “recurrent pregnancy loss”?
According to ACOG, recurrent pregnancy loss is generally defined as two or more miscarriages, and evaluation is typically recommended after the second one.
If no cause is ever found, does that mean I can’t have a healthy pregnancy?
No. ACOG reports that about 65 in 100 women with unexplained recurrent pregnancy loss go on to have a successful next pregnancy without special treatment.
What kinds of tests are typically part of an evaluation?
A history and physical exam, blood tests for immune-related causes, genetic testing, and imaging of the uterus are the general categories ACOG describes. Your provider decides which ones apply to you.
Did I cause my miscarriages?
Almost certainly not. ACOG states that miscarriages are almost never linked to anything you did or did not do — most are tied to a random chromosome event during fertilization.
Related Reading
- Learn when a general fertility evaluation is typically recommended
- Understand menstrual cycles and ovulation
- Preparing your health before trying to conceive again
- Read our full Medical Disclaimer
Educational Disclaimer
This article is for general educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. It does not recommend any specific test or treatment for any individual. Whether evaluation is appropriate, and what it should include, depends on a person’s own history and symptoms. Always consult a qualified health care provider about your specific situation.