Recurrent miscarriage, also referred to as recurrent pregnancy loss, is defined as the loss of two or more consecutive pregnancies before fetal viability. While isolated miscarriage is relatively common, recurrent miscarriage represents a complex reproductive condition that warrants thorough medical evaluation. It carries significant physical and emotional implications for individuals and couples and often requires a multidisciplinary, structured diagnostic approach.

The causes of recurrent miscarriage are diverse and may involve genetic, anatomical, hormonal, immunological, and systemic factors. Chromosomal abnormalities are among the most frequent contributors, particularly structural rearrangements that may be present in one of the partners. Uterine structural abnormalities, including congenital uterine anomalies, fibroids, adhesions, or cervical weakness, can interfere with implantation or fetal development and lead to pregnancy loss.

Hormonal factors also play a critical role. Conditions such as luteal phase deficiency, thyroid disorders, uncontrolled diabetes, and polycystic ovary syndrome may disrupt the hormonal environment required to sustain early pregnancy. Immunological causes, including antiphospholipid syndrome and other autoimmune conditions, can impair placental development and increase the risk of thrombosis within placental vessels, leading to pregnancy failure.

Infections, lifestyle factors, advanced maternal age, and chronic medical illnesses may further contribute to recurrent miscarriage risk. In a significant proportion of cases, no single definitive cause is identified despite extensive evaluation, a scenario known as unexplained recurrent miscarriage.

Evaluation involves a comprehensive assessment of reproductive anatomy, genetic testing when indicated, hormonal profiling, screening for clotting disorders, and evaluation of systemic health. Each investigation is selected based on clinical history and previous pregnancy outcomes. Emotional distress and psychological burden are common, and the impact of repeated pregnancy loss extends beyond physical health, affecting mental well-being, relationships, and future reproductive decisions.

Management of recurrent miscarriage focuses on addressing identified causes and optimizing conditions for future pregnancy. Even in cases where no clear etiology is found, many individuals go on to achieve successful pregnancies with careful monitoring and supportive care. Early pregnancy surveillance, timely intervention, and individualized management significantly improve outcomes.

Recurrent miscarriage is a challenging condition, but advances in diagnostic evaluation and personalized care have improved the likelihood of achieving and sustaining a healthy pregnancy. A structured approach provides both medical clarity and reassurance during a difficult reproductive journey.