After more than one miscarriage, look for a reason.
Losing a pregnancy is painful, and losing more than one can leave a couple afraid to try again. We look for the reasons behind repeated miscarriage, treat what can be treated, and stay close to you through the next pregnancy — with scans, laboratory tests and hysteroscopy in the same hospital.
What recurrent pregnancy loss means.
Recurrent pregnancy loss, also called recurrent or repeated miscarriage, usually means two or more pregnancies lost before 20 to 24 weeks. A single early miscarriage is common and usually happens by chance. When it happens again, it is worth looking for a cause.
The causes that can be found include a womb that is shaped differently or has a septum, polyps or fibroids inside it; a weak cervix that opens too early; thyroid problems or uncontrolled diabetes; antiphospholipid syndrome, a condition that makes the blood clot more easily; and, less often, a chromosome change carried by one of the parents.
In about half of couples no cause is found even after full tests. That is not the end of the road: many of these couples go on to have a healthy baby with careful monitoring and support in the next pregnancy.
Both partners
History and tests for the couple, because some causes come from either side.
3D/4D sonography
Detailed scans of the womb in-house, and early scans in the next pregnancy.
Hysteroscopy
A look inside the womb, and correction of a septum or polyp in the same sitting.
Counselling
Time to talk about what happened and what the results mean, without being rushed.
What this covers at our hospital.
Looking for a cause
- Detailed history of each pregnancy loss
- Pelvic ultrasound, including 3D scanning of the womb
- Hysteroscopy to see inside the womb
- Thyroid, sugar and hormone blood tests
- Tests for antiphospholipid antibodies
- Chromosome tests for the couple when advised
Treatment
- Hysteroscopic removal of a septum, polyp or scar tissue
- Correcting thyroid problems and blood sugar before conception
- Blood-thinning treatment when antiphospholipid syndrome is found
- Cervical stitch where a weak cervix is the cause
- Hormone support in early pregnancy when advised
- Planning before the next pregnancy
Care in the next pregnancy
- An early visit as soon as the test is positive
- Early scans to check the pregnancy is growing
- Regular reviews through the first weeks
- A clear number to call if there is bleeding or pain
- Antenatal care and delivery in the same hospital
Step by step.
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01
Consultation
Come together if you can. The doctor goes through each pregnancy loss with you and explains which tests are needed and why.
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02
Tests
Blood tests and a scan, and a hysteroscopy if the womb needs a closer look. Some tests are timed to the cycle.
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03
A plan
You are told what the results show, what can be treated, and what to do before and in the next pregnancy.
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04
The next pregnancy
Early scans and regular visits from the first positive test, with the same team through to delivery.
What patients ask us.
After how many miscarriages should we get tested?
Tests are usually advised after two or more pregnancy losses. Come sooner if you are over 35, if a loss happened after the first three months, or if you already know of a problem such as a thyroid condition or an unusually shaped womb.
Was the miscarriage caused by something I did?
Almost never. Normal work, travel, exercise, intercourse and everyday stress do not cause miscarriage. Most early losses happen because the pregnancy was not developing normally from the start.
What if all the tests come back normal?
That is common, and it is often reassuring. Many couples with no cause found go on to have a healthy baby. Early scans and close support in the next pregnancy still help, and the doctor will explain what is and is not worth trying.
What should we bring to the first visit?
Reports, scans and discharge papers from each pregnancy, any test results, and a list of the medicines you were given. Dates and the week of pregnancy at each loss are very useful.
This page is general information, not medical advice for your own case. Your consultant will advise you after an examination.
Other specialist care at the hospital.
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Key-hole gynaecological and general surgery through small cuts, for less pain, smaller scars and a quicker return home.
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Tests, treatment and counselling for couples finding it hard to conceive, with both partners looked after together.
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Intrauterine insemination with follicle tracking by scan and semen preparation in the hospital’s own IUI lab.
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Closer checks, earlier scans and a delivery plan made in advance, for pregnancies that need more than routine care.
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