Two or three miscarriages does not mean you cannot have a baby. It means something specific is stopping your pregnancies — and we can find it. At Mother Hospitals, 80% of our recurrent pregnancy loss patients go on to deliver a healthy baby.
Recurrent miscarriage — medically called Recurrent Pregnancy Loss (RPL) — is defined as 2 or more pregnancy losses before 20 weeks. It is different from a single miscarriage, which is common. With RPL, there is usually an underlying reason that keeps repeating.
Most causes of recurrent pregnancy loss are treatable. Here is what our RPL panel looks for:
| Cause | How Common | Tests Used | Treatability |
|---|---|---|---|
| Chromosomal (embryo) — abnormal embryos that cannot develop | 50–60% of early losses | Karyotyping, PGT-A | IVF+PGT-A |
| Uterine abnormalities — septum, fibroids, polyps, adhesions | 15–20% | Ultrasound, Hysteroscopy, 3D scan | Highly Treatable |
| Antiphospholipid syndrome (APS) — blood clots in placenta | 10–15% | APA, anti-beta2 GP, Lupus anticoagulant | Highly Treatable |
| Hormonal imbalances — thyroid, prolactin, progesterone, PCOS | 10–15% | TSH, prolactin, LH, FSH, AMH, progesterone | Highly Treatable |
| Thrombophilia — inherited clotting disorders (MTHFR, Factor V Leiden) | 5–10% | Thrombophilia screen, homocysteine | Treatable with anticoagulants |
| Male factor — high sperm DNA fragmentation | 5–8% | Sperm DNA fragmentation (DFI) test | Treatable with antioxidants / ICSI |
| Immune factors — elevated Natural Killer cells, alloimmune | 5–10% | NK cell assay, HLA typing | Specialist treatment available |
| Unexplained RPL — no identifiable cause found | 30–40% | Full workup returns normal | 70% success with supportive care |
At Mother Hospitals Boduppal, we run a structured RPL clinic. Here is what to expect when you come to us after recurrent pregnancy loss:
We map every pregnancy — gestational age at loss, symptoms, any heartbeat seen, results of any previous tests, and medications taken. Pattern recognition matters: losses at 5–6 weeks point to different causes than losses at 8–10 weeks.
A 3D pelvic ultrasound checks for uterine septum, fibroids, and polyps. If suspicious, we proceed to diagnostic hysteroscopy — a camera inside the uterus — to see and fix problems directly. A uterine septum, for example, doubles miscarriage risk and can be corrected in a single outpatient procedure.
TSH, Free T3, Free T4, prolactin, FSH, LH, AMH, progesterone on Day 2–3, fasting insulin, and DHEAS. Hormonal imbalances — especially undiagnosed thyroid disease and high prolactin — are among the most correctable causes of RPL.
Blood tests for APA, anti-beta2 glycoprotein, lupus anticoagulant, homocysteine, Factor V Leiden, Protein C & S, and MTHFR mutation. If positive, treatment with low-dose aspirin and low molecular weight heparin dramatically improves outcomes — live birth rates improve from 10% to 70–80%.
A blood test that checks if either partner carries a balanced chromosomal translocation. This is rare (3–5%) but explains repeated abnormal embryos. If found, IVF with PGT-A (preimplantation genetic testing) selects normal embryos before transfer.
High sperm DNA damage leads to embryos that start dividing but then arrest — appearing as early miscarriages. A DFI (DNA Fragmentation Index) above 25% needs treatment. Antioxidants, lifestyle changes, and ICSI with testicular sperm can resolve this.
All results are reviewed together and a customised plan is made. For some it is a simple hormonal correction. For others, hysteroscopic surgery + progesterone support. For chromosomal cases, IVF with PGT-A. You will know exactly what the next pregnancy needs to be different.
Based on what your investigations find, here are the evidence-based treatments we use:
For couples where chromosomal abnormalities in embryos are the cause. PGT-A screens all embryos before transfer — only chromosomally normal embryos are transferred. This drops miscarriage rate per transfer to under 10%.
For uterine septum, polyps, fibroids inside the cavity, or Asherman's adhesions. Done as a day procedure under short anaesthesia. After correction, the uterus is rechecked and pregnancy success rates improve significantly.
Luteal phase defect (low progesterone) is a correctable cause. Vaginal progesterone or oral dydrogesterone from ovulation or embryo transfer, continued through 12–16 weeks, significantly reduces loss risk.
For antiphospholipid syndrome and thrombophilia. Low-dose aspirin (75 mg daily from conception) plus low molecular weight heparin injections through pregnancy converts a 10% live birth rate into 70–80%. Simple and highly effective.
Getting TSH below 2.5 before conception with levothyroxine. Thyroid management continues throughout pregnancy as requirements increase by 30–50%. Unmanaged hypothyroidism during pregnancy is a leading, preventable cause of repeated loss.
For high DFI (sperm DNA fragmentation). Medical antioxidant therapy for 3 months (CoQ10, L-carnitine, vitamin E, zinc), followed by re-test. For severe cases, testicular sperm extraction (TESE-ICSI) bypasses damaged sperm entirely.
When investigations are all normal, we do not leave you without a plan. Evidence supports:
With this supportive protocol, 70% of couples with unexplained RPL carry a pregnancy to term.
Recurrent miscarriage is not just a medical condition. Each loss is a grief. The fear of trying again, the anxiety of every early scan, the isolation of not knowing whether to tell people you are pregnant — these are real, and we see them every day.
MD (OBG) · Fertility & IVF Specialist · TGMC Reg: 50624
19+ years specialising in reproductive medicine including recurrent pregnancy loss, IVF, and high-risk obstetrics at Mother Hospitals, Boduppal, Hyderabad.
RPL Clinic: Monday–Saturday · Call 97059 93366 or WhatsApp 97059 93355