Pregnancy Loss: When Should You Seek Help?
Pregnancy loss can leave you with more questions than answers.
Why did this happen?
Was there something you could’ve done differently?
What does it mean for another pregnancy?
And when should you talk with your doctor about looking for a possible cause?
These are understandable questions.
A single pregnancy loss doesn't necessarily mean there's an underlying fertility or reproductive health problem. Many early miscarriages happen because of chromosome changes that occur by chance.
But when pregnancy losses happen more than once, or when there are other fertility or health concerns, it may be worth taking a closer look.
How common is pregnancy loss?
Pregnancy loss is more common than many people realize.
And although it can be natural to search for something that explains what happened, there isn't always one clear answer.
Chromosomal abnormalities are among the most common causes of early miscarriage. These occur when an embryo develops with an abnormal number of chromosomes, and the likelihood of chromosome-related loss increases with maternal age.
Experiencing one miscarriage doesn't automatically mean the same thing will happen again.
When does pregnancy loss become recurrent?
You may hear the term recurrent pregnancy loss, or RPL.
Current guidance from the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine defines recurrent pregnancy loss as two or more miscarriages. A more detailed evaluation may be recommended after two losses.
That doesn't mean you're required to wait until a certain number of losses before asking questions.
If you have concerns about your reproductive health, difficulty becoming pregnant, known gynecologic conditions, or another reason to be concerned, it's reasonable to bring those questions to your provider.
Why do miscarriages happen?
There isn't one single cause of pregnancy loss.
Sometimes a reason can be identified. Other times, testing may not provide a definite explanation.
When pregnancy loss happens repeatedly, your doctor may consider several parts of your health and reproductive history.
These may include:
Chromosomal or genetic factors
The shape and structure of the uterus
Certain immune conditions
Hormonal or metabolic factors
Age
Previous pregnancies and pregnancy losses
Other individual health factors
The goal isn't to assume one of these factors is responsible.
It's to understand whether there's something worth investigating further.
Can problems with the uterus contribute to pregnancy loss?
Sometimes.
The structure of the uterus can be part of a recurrent pregnancy loss evaluation.
Certain congenital differences in the uterus, scar tissue inside the uterine cavity, fibroids, or other structural changes may be considered depending on your individual history.
Current ASRM guidance recommends evaluation of the uterine cavity for patients with recurrent pregnancy loss. This may involve imaging or a procedure that allows your provider to better evaluate the inside of the uterus.
Having a fibroid or another uterine finding doesn't automatically mean it caused a miscarriage.
Location, size, and your complete reproductive history matter.
What role do genetics play?
Genetic factors can also be part of the conversation.
Many isolated miscarriages happen because of random chromosome abnormalities in the developing embryo.
With recurrent pregnancy loss, additional genetic evaluation may sometimes be discussed.
The latest ASRM guidance recommends offering chromosome analysis of miscarriage tissue as part of the evaluation of recurrent pregnancy loss when feasible. Other genetic testing may be considered depending on those results and the patient's history.
Not every patient will need the same testing.
Can hormones or metabolic health affect pregnancy?
Your overall health can also be relevant.
Depending on your symptoms and risk factors, your doctor may consider conditions involving thyroid function, blood sugar, ovulation, or other hormonal and metabolic concerns.
For example, current recurrent pregnancy loss guidance recommends targeted testing for certain metabolic or hormonal conditions when a patient's history or symptoms suggest they could be involved.
This is another reason a complete health history matters.
Pregnancy doesn't happen separately from the rest of your health.
Does age affect miscarriage risk?
Age is one factor doctors may consider.
As egg age increases, chromosome abnormalities become more common, which is one reason miscarriage risk rises with maternal age.
But age doesn't tell your entire story.
Someone younger can experience recurrent losses, and many people over 35 go on to have healthy pregnancies.
Your doctor should look at your individual history rather than making assumptions based on age alone.
What happens during a recurrent pregnancy loss evaluation?
There isn't one universal test that explains every pregnancy loss.
Your first appointment may begin with a detailed conversation about:
Your previous pregnancies
When pregnancy losses occurred
Your menstrual cycles
Previous fertility concerns
Medical conditions
Medications
Previous surgeries
Family history
Your partner's health history
Depending on your situation, testing may include evaluation of the uterine cavity, genetic testing, or specific blood tests based on your history and symptoms.
Not every possible test is recommended for every patient.
A targeted evaluation can help avoid unnecessary testing while still looking carefully at the factors most relevant to you.
What if testing doesn't find a cause?
This can be frustrating.
Sometimes a thorough evaluation still doesn't identify one clear reason for recurrent pregnancy loss.
That doesn't mean the loss wasn't real or that your questions were unnecessary.
It also doesn't mean another successful pregnancy isn't possible.
ACOG reports that even when no cause is found, about 65 out of 100 women with unexplained recurrent pregnancy loss have a successful next pregnancy.
The next step should depend on your health, reproductive goals, test results, and what feels appropriate for you.
Questions to ask your doctor after pregnancy loss
You don't need to arrive at your appointment already knowing what testing you need.
Consider asking:
Does my pregnancy history suggest I need further evaluation?
Should my uterus be evaluated?
Could fibroids or another uterine condition be relevant?
Are there hormonal or metabolic issues we should consider?
Would genetic testing provide useful information?
Does my age change what you recommend?
Should my partner be evaluated?
Is there anything I should do before trying again?
When would you recommend additional testing?
What happens if testing doesn't identify a cause?
Sometimes the most useful first step is simply having the conversation.
It's okay to have questions after pregnancy loss
October is Pregnancy and Infant Loss Awareness Month.
For some people, that recognition brings comfort. For others, it may bring difficult feelings or memories.
There isn't one right way to respond to pregnancy loss or one right timeline for deciding what comes next.
If you've experienced one loss and have questions, you're allowed to ask them.
If you've experienced repeated losses, difficulty becoming pregnant, or other reproductive health concerns, a more detailed evaluation may help you better understand whether there's something your doctor should investigate.
At The Kaldas Center, we take the time to listen to your complete story, understand your reproductive history, and help you determine whether additional evaluation may be appropriate.
Schedule an appointment with The Kaldas Center to start getting answers.
Medical Disclaimer
This article is for educational purposes only and isn't a substitute for professional medical advice, diagnosis, or treatment. Pregnancy loss can have many possible causes, and recommendations for testing or treatment depend on your individual health and reproductive history. Speak with a qualified healthcare provider about your specific situation.
Sources
American College of Obstetricians and Gynecologists: Repeated Miscarriages.
American College of Obstetricians and Gynecologists: Early Pregnancy Loss.
American Society for Reproductive Medicine: Recurrent Pregnancy Loss: A Committee Opinion, 2026.