Miscarriage before 20 weeks is evaluated as pregnancy loss. Stating that 10–15% of clinically detected pregnancies result in miscarriage, Liv Hospital Obstetrician and Perinatology Specialist Prof. Dr. Arda Lembet said, “Genetic factors (abnormal count or structure of embryo chromosomes) are responsible for 50–75% of pregnancy losses. About 1% of fertile women suffer from three or more miscarriages, and these cases are called recurrent pregnancy loss.”
Emphasizing that Recurrent Pregnancy Losses are Preventable, Spec. MD. Hafsa Uçur explained the causes of pregnancy losses and provided a roadmap for effective prevention. Although a miscarriage is a deeply emotional experience, understanding its underlying causes helps doctors and families take preventive steps for future pregnancies.
When Should Pregnancy Losses Be Examined?
If a heartbeat is detected in the embryo, or especially if a miscarriage occurs during the second trimester, further evaluation is strongly recommended. In many cases, investigations for Recurrent Pregnancy Losses begin after two consecutive miscarriages, even though the classic definition involves three or more consecutive losses. However, any miscarriage that happens after 12 weeks or during the second trimester is enough reason to start diagnostic evaluation, as early testing can help prevent future Recurrent Pregnancy Losses and support healthier pregnancy outcomes.
Certain situations increase the need for early testing and monitoring, such as:
- A normal karyotype analysis reported from tissue collected in a previous pregnancy loss
- Maternal age over 35
- Infertility or previous difficulty conceiving
- Abnormal results in the karyotype (genetic) analysis of the mother and/or father
If these conditions are present, doctors recommend genetic, anatomical, and hormonal assessments before attempting another pregnancy. Early detection of potential issues can improve pregnancy outcomes and reduce the risk of future losses.
What Are the Causes of Recurrent Pregnancy Loss?
Recurrent pregnancy loss can have multiple causes, and identifying the right one requires a comprehensive approach. The most common factors include:
1-Anatomic Factors
Structural issues in the uterus can lead to pregnancy loss. These may be congenital, such as uterine septum, unicornuate uterus, uterine didelphys, or bicornuate uterus, or acquired, such as fibroids (myomas) and intrauterine adhesions (Asherman’s syndrome). These conditions may prevent proper implantation or limit the growth of the embryo.
2-Immune System Factors
Autoimmune diseases such as systemic lupus erythematosus or antiphospholipid syndrome can cause the body’s immune system to mistakenly attack pregnancy-related tissues, leading to miscarriage. These disorders often require specialized tests and, if detected, can be managed with targeted therapies to protect the pregnancy.
3-Genetic and Chromosomal Factors
Abnormalities in the chromosomes of the embryo, or sometimes in the parents, are responsible for 50–75% of early miscarriages. When the chromosomal number or structure is abnormal, the embryo cannot develop normally. A karyotype analysis of both parents helps determine whether there are any inherited genetic issues.
4-Coagulation and Placental Problems
Congenital thrombophilias (blood clotting disorders) and placenta-related pathologies can restrict blood flow to the embryo. In these cases, proper diagnosis allows treatment through medication that improves blood circulation and reduces clotting risk.
What Diagnostic Procedures Are Used?
To identify the causes of pregnancy loss, doctors use a range of genetic, imaging, and laboratory methods.
- Karyotype Analysis: A genetic test using blood samples from the mother and father to detect chromosomal abnormalities.
- Advanced Imaging: Techniques like 4D ultrasonography, hysterosalpingography (imaging of uterus and fallopian tubes with contrast dye), hysteroscopy, and laparoscopy help detect structural or anatomical abnormalities.
- Thrombophilia and Immunological Testing: These blood tests evaluate congenital or acquired clotting disorders and immune-related causes. The thrombophilia panel, genetic mutation screening, and lipoprotein(a) measurement are key parts of this evaluation.
- Prenatal Chromosomal Analysis: For women who become pregnant after previous losses, chromosomal analysis during pregnancy—through amniocentesis, chorionic villus sampling (CVS), or cordocentesis—provides essential genetic information.
Early diagnosis not only helps identify the cause but also allows the medical team to plan personalized treatment before and during pregnancy.
Can Recurrent Pregnancy Loss Be Prevented?
Yes. With modern diagnostic tools and targeted treatments, most recurrent pregnancy losses are preventable. Once the underlying reason is identified, medical specialists can recommend appropriate therapies, including hormonal support, blood-thinning medications, surgical correction of uterine abnormalities, or lifestyle adjustments.
Emotional support and regular follow-up with obstetric and perinatology specialists also play a crucial role. Today, many women with previous miscarriages go on to have healthy pregnancies and healthy babies thanks to comprehensive evaluation and personalized care.
* Liv Hospital Editorial Board has contributed to the publication of this content .
* Contents of this page is for informational purposes only. Please consult your doctor for diagnosis and treatment. The content of this page does not include information on medicinal health care at Liv Hospital .
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