Recurrent Miscarriage: A Shared Pain
Miscarriage is a painful experience for any woman, but when it happens multiple times consecutively, the pain multiplies. Recurrent pregnancy loss is defined as 2 or more consecutive spontaneous miscarriages before week 20 of pregnancy.
According to statistics, approximately 15-20% of pregnancies end in miscarriage, and about 1-2% of couples experience recurrent miscarriage. However, the good news is that with advances in modern medicine, most cases can have an identifiable cause and be effectively treated.
Causes of Recurrent Miscarriage
1. Chromosomal abnormalities
This is the most common cause, accounting for approximately 50-60% of cases. Chromosomal abnormalities can come from:
- The embryo: Random errors during cell division — the most common cause
- Father or mother: Approximately 3-5% of couples with recurrent miscarriage have a structural chromosomal abnormality (balanced translocation) that doesn’t affect their own health but increases the risk of creating abnormal embryos
2. Uterine structural abnormalities
Accounting for approximately 10-15% of cases, including:
- Uterine septum: A wall dividing the uterine cavity that hinders embryo implantation and growth
- Bicornuate uterus: Congenital shape abnormality
- Uterine fibroids: Especially submucosal fibroids compressing the uterine cavity
- Uterine polyps: Obstruct embryo implantation
- Intrauterine adhesions (Asherman syndrome): Often from previous uterine curettage
3. Immune disorders
Accounting for approximately 15-20% of cases:
- Antiphospholipid syndrome (APS): The most common immune cause, creating blood clots in placental vessels that obstruct fetal nourishment
- Other autoimmune disorders: Systemic lupus erythematosus, autoimmune thyroid disease
4. Endocrine disorders
- Luteal insufficiency: Insufficient progesterone to maintain early pregnancy
- Thyroid disorders: Both hyperthyroidism and hypothyroidism increase miscarriage risk
- Polycystic ovary syndrome (PCOS): Insulin resistance and hormonal imbalance
- Uncontrolled diabetes: High blood sugar affects embryo development
5. Coagulation disorders
Inherited thrombophilia conditions such as Factor V Leiden mutation, prothrombin G20210A mutation can cause placental vessel thrombosis, leading to miscarriage.
6. Lifestyle and environmental factors
- Smoking or secondhand smoke exposure
- Alcohol consumption
- Exposure to harmful chemicals
- Prolonged stress
- Being underweight or overweight
7. Unexplained causes
Approximately 25-50% of recurrent miscarriage cases have no identifiable cause. However, this is not necessarily bad news — research shows these cases still have a high success rate in the next pregnancy.
Required Tests
When visiting Phong Kham Bac Sy Lam, couples will be ordered appropriate tests:
Tests for both partners
- Karyotype: Detect structural chromosomal abnormalities
Tests for the wife
- Uterine/ovarian ultrasound: Evaluate uterine structure, detect fibroids, polyps
- Hysterosalpingography (HSG): Evaluate the uterine cavity and fallopian tubes
- Antiphospholipid antibody tests: Anticardiolipin, lupus anticoagulant, anti-beta2 glycoprotein I
- Coagulation tests: D-dimer, fibrinogen, coagulation factors
- Hormonal tests: TSH, FT4, progesterone, blood glucose, insulin
- Inherited thrombophilia tests: Factor V Leiden, prothrombin G20210A (when indicated)
Treatment Methods
Treatment by cause
Chromosomal abnormalities:
- Genetic counseling for the couple
- Consider IVF with preimplantation genetic testing (PGT)
Uterine structural abnormalities:
- Hysteroscopic septum resection
- Hysteroscopic polyp removal, fibroid excision
- Adhesion lysis
Antiphospholipid syndrome:
- Low-dose aspirin (75-100 mg/day) combined with low molecular weight heparin
- Begin treatment as soon as pregnancy is confirmed and continue throughout
Endocrine disorders:
- Progesterone supplementation (vaginal or injection) during the first trimester
- Treat thyroid disease, control blood sugar
- Metformin for PCOS patients with insulin resistance
Coagulation disorders:
- Low molecular weight heparin per protocol
Psychological support
Recurrent miscarriage causes severe psychological trauma. Dr. Lam always takes time to listen, counsel, and encourage couples. Emotional support plays a role equally important as medical treatment.
Monitoring the Next Pregnancy
When pregnant again, mothers with a history of recurrent miscarriage need closer monitoring than usual:
- Early ultrasound to confirm heartbeat (weeks 6-7)
- Prenatal visits every 1-2 weeks during the first trimester
- Regular hormonal and coagulation monitoring
- Frequent ultrasounds to assess fetal development
- Continue prescribed medications (progesterone, heparin, aspirin…)
Preparing Before Trying Again
After identifying the cause and receiving treatment, preparation before the next pregnancy is crucial:
Physical health
- Supplement folic acid 400-800 mcg/day, starting at least 3 months before conception
- Control weight: Ideal BMI 18.5-24.9
- Check and treat underlying conditions: thyroid, diabetes, hypertension
- TORCH testing (Toxoplasma, Rubella, CMV, Herpes) if no immunity
- Vaccinate for rubella if no antibodies (wait 3 months after vaccination before conceiving)
- Quit smoking and alcohol at least 3 months before trying to conceive
Mental health
Recurrent miscarriage leaves deep psychological scars. Before trying again, both partners should:
- Wait until emotionally ready, don’t rush
- Seek psychological counseling if feeling excessive anxiety or fear
- Share emotions with each other and with the treating doctor
- Recognize that the next pregnancy is a new pregnancy with a high chance of success
Tests to complete before conception
- Karyotype for both partners (if not yet done)
- Antiphospholipid antibody tests (need 2 positive results 12 weeks apart for confirmation)
- Thyroid tests: TSH, FT4, TPO antibodies
- Ultrasound to reassess the uterine cavity after treatment (if surgery was performed)
- Comprehensive coagulation testing
The Husband’s Role
The husband plays a very important role in the recurrent miscarriage treatment process:
- Attend appointments together: Karyotype testing and semen analysis
- Emotional support: Listen, share, and accompany throughout the treatment process
- Lifestyle changes: Quit smoking and alcohol, reduce stress to improve sperm quality
- Understanding and compassion: Recurrent miscarriage has a severe psychological impact on women, requiring patience and empathy from the husband
When Should You See a Doctor?
You should seek medical attention immediately if:
- 2 or more consecutive miscarriages
- Miscarriage in the second trimester (after week 12) — suggests cervical insufficiency or uterine abnormality
- Miscarriage with coagulation disorders or history of thrombosis
- Family history of recurrent miscarriage or genetic abnormalities
- Currently have autoimmune conditions (lupus, Hashimoto’s thyroiditis)
- Over 35 years old with miscarriage, as reproductive time is limited and early evaluation is needed
Related Articles
- High-risk pregnancy: Who needs special monitoring? — Managing pregnancy after recurrent miscarriage
- Prenatal screening tests — Necessary tests in the subsequent pregnancy
- Infertility consultation: Process — When recurrent miscarriage causes reproductive difficulties
- Prenatal care services at Phong Kham Bac Sy Lam — Specialized pregnancy monitoring
Advice From the Doctor
Dr. Lam shares: “With over 30 years of experience, formerly working at the National Cancer Institute, Hanoi Medical University Hospital, Hanoi Andrology Hospital, and Medlatec Hospital, I have accompanied many couples through the pain of recurrent miscarriage. The most important message is don’t give up. Modern medicine now has many effective methods, and the success rates are very encouraging. Come for an evaluation to find the cause and receive appropriate treatment.”
If you or a loved one is experiencing recurrent miscarriage, contact us immediately for specialized consultation.
Book a Consultation
Don’t bear the pain alone — let us accompany you on the journey to finding the joy of motherhood again.
Phong Kham San Phu Khoa Bac Sy Lam
- Address: 125 Ham Nghi, Kim Tan, Lao Cai
- Phone: 0986 321 000
- Working hours: Monday – Saturday
Book now: 0986 321 000 — 125 Ham Nghi, Kim Tan, Lao Cai
