Medically reviewed by Dr. Shweta Agarwal, MBBS, DGO. Last updated: June 2026.
Information on this page is educational and does not replace a medical consultation. Outcomes depend on individual clinical factors.
What does recurrent pregnancy loss mean — and is there hope?
Recurrent pregnancy loss describes repeated miscarriages, usually consecutive, in the first or early second trimester. A single miscarriage is common and often a one-off event. When losses repeat, it is reasonable — and recommended — to look for a cause.
Two facts are important to hold onto:
- In many couples, no single cause is ever found. This can feel frustrating, but it often carries a more hopeful outlook than people expect.
- A history of recurrent loss does not mean you cannot carry a pregnancy. A large proportion of couples go on to have a successful pregnancy, including those for whom no specific cause is identified.
In Marathi and Hindi, this is often described as वारंवार गर्भपात or बार बार गर्भपात — terms your doctor may use gently in consultation. There is no blame here. RPL is a medical situation, not a personal failing.
What can cause recurrent pregnancy loss?
RPL can have several contributing factors, and sometimes more than one is present. Often, no clear cause is found ("unexplained") — which, reassuringly, is associated with a good chance of a future successful pregnancy. Recognised contributors include:
- Genetic and chromosomal factors: The most common cause of an individual early miscarriage is a random chromosomal abnormality in the embryo. In a small number of couples, one partner carries a balanced chromosomal rearrangement (such as a translocation) that raises the risk of recurrent loss.
- Uterine (structural) factors: A uterine septum, certain fibroids, intrauterine adhesions (Asherman's syndrome), or congenital uterine anomalies can interfere with implantation or pregnancy continuation.
- Hormonal and metabolic factors: Thyroid disorders, poorly controlled diabetes, and conditions such as PCOS or luteal phase problems can play a role.
- Antiphospholipid syndrome (APS) and thrombophilias: Certain clotting disorders, particularly antiphospholipid syndrome, are an established and treatable cause of recurrent loss.
- Infections: Some infections may contribute, though their role in true recurrent loss is more limited.
- Endometriosis: Endometriosis is sometimes associated with pregnancy difficulties.
- Age and lifestyle: Increasing maternal age raises the baseline risk of chromosomally abnormal pregnancies. Smoking, heavy alcohol use, and other lifestyle factors can also contribute.
- Unexplained: In a significant share of couples, no cause is identified despite a thorough workup.
Does recurrent pregnancy loss cause symptoms between pregnancies?
Usually there are no symptoms between pregnancies — most underlying causes are silent and are found only through investigation. The losses themselves carry the symptoms of miscarriage (such as bleeding and cramping), but in the time between pregnancies, a woman typically feels well.
This is exactly why a structured set of tests — the RPL workup — is offered: it looks for causes that would otherwise be invisible.
How is recurrent pregnancy loss investigated?
The aim of the RPL workup is to look carefully for a treatable cause, while recognising that not finding one is itself common and often reassuring. Dr. Shweta Agarwal tailors the investigations to your history. The assessment typically includes:
Detailed history and examination
A careful review of each pregnancy and loss, your menstrual and medical history, and any family history.
Genetic testing
Karyotyping (chromosome analysis) of both partners can identify a balanced rearrangement. Where appropriate, testing of pregnancy tissue from a loss may also be considered.
Uterine assessment
Imaging of the uterine cavity to look for a septum, fibroids, or adhesions — using ultrasound and, where indicated, a hysteroscopy to view the cavity directly and treat some problems in the same procedure.
Hormonal and metabolic screen
Thyroid function, blood glucose/diabetes screening, and other hormonal tests as indicated.
Immunological and clotting screen
Testing for antiphospholipid syndrome and relevant thrombophilias, since these are treatable.
These investigations are available in-house — see our fertility diagnostics page for the full panel. Not every couple needs every test; the workup is individualised.
What can help after recurrent pregnancy loss?
Treatment is directed at whatever cause is found — and where no cause is found, supportive care with close monitoring in a future pregnancy is itself a recognised and reassuring approach.
Treating an identified cause
- Uterine factors: A uterine septum or adhesions can often be corrected surgically — for example, hysteroscopic resection of a septum. See hysteroscopy.
- Antiphospholipid syndrome: Where APS is confirmed, treatment with low-dose aspirin and heparin during pregnancy is an established approach that improves outcomes.
- Hormonal/metabolic factors: Optimising thyroid function and blood glucose, and managing conditions such as PCOS, before and during pregnancy.
Genetic factors and PGT
Where a chromosomal rearrangement is identified in a partner, or where chromosomal embryo abnormalities are a likely driver, IVF with pre-implantation genetic testing (PGT) may be discussed. PGT is used here only to assess the chromosomal health of embryos — it is never used for sex selection, which is prohibited by law (PCPNDT Act).
Supportive ("tender") care for unexplained loss
For unexplained RPL, close monitoring, reassurance, and supportive care in early pregnancy are associated with good outcomes for many couples.
You are not alone — emotional support matters
Recurrent loss is grief, repeated. It is normal to feel sadness, anxiety, anger, guilt, or numbness — sometimes all at once, and sometimes long after a loss. These feelings are valid, and they do not mean anything is wrong with you.
A few things that many couples find helpful:
- Allow yourself to grieve. A loss at any stage of pregnancy is a real loss. There is no "too early" to grieve.
- Lean on each other and on people you trust. Partners often grieve differently; that difference is not distance.
- Ask for support without shame. Counselling and support are part of good care, not a sign of weakness.
- Take the next step when you feel ready. There is no fixed timeline, and your care team will move at a pace that respects where you are.
Dr. Shweta Agarwal and the team provide care in Marathi, Hindi, and English, so that you can talk through your loss and your questions in the language you are most comfortable with.
When should we seek help?
Please consider an evaluation if:
- You have experienced repeated, consecutive pregnancy losses.
- You have had a loss in the second trimester.
- You have an existing condition such as thyroid disorder, diabetes, PCOS, or a known clotting disorder.
- You simply want to understand what happened and what your options are — you do not have to wait for a specific number of losses to ask questions.
Seeking evaluation is not about blame; it is about information and care. Aansh Hospital & IVF Center offers a supportive, unhurried consultation.