Treatment for recurrent miscarriages

Repeated miscarriages can be very distressing. Care combines an appropriate assessment, treatment when there is a specific indication, and support in planning the next steps. There is no single treatment for every situation.

When should you seek advice after repeated miscarriages?

A specialist consultation may be offered after two pregnancy losses, depending on the circumstances. Definitions differ between guidelines: some use two losses and others three. Assessment should not be restricted to women under 40.

Which investigations may be useful?

Assessment starts with both partners’ medical histories and the available information about each pregnancy. Depending on the circumstances, it may include evaluation of the uterus, thyroid tests and testing for antiphospholipid syndrome (APS).

Genetic testing may be discussed, including testing of miscarriage tissue or parental testing. An endometrial biopsy or sperm DNA fragmentation testing may be considered in selected situations; these investigations are not routine for everyone. Broad immune testing or inherited thrombophilia screening is not offered to every patient.

What is the role of aspirin and heparin?

For confirmed APS with a compatible pregnancy history, low-dose aspirin combined with heparin may be indicated. Timing and monitoring are individualised. These medicines are not a routine treatment for unexplained recurrent miscarriage.

When might hormone treatment be offered?

Thyroid disease or diabetes should be managed before and during pregnancy. Progesterone is not a universal solution: it may be offered in specific circumstances, particularly when there is early pregnancy bleeding, an intrauterine pregnancy has been confirmed by ultrasound, and the woman has had a previous miscarriage.

Is uterine surgery always helpful?

Some abnormalities of the uterine cavity may lead to a discussion about surgery. The decision depends on the abnormality, its location and the balance of benefits and risks. A reduction in miscarriage risk has not been established in every situation.

IVF, PGT-A and targeted testing: what is available in France?

In France, preimplantation genetic testing for aneuploidy (PGT-A), which screens embryos for abnormalities in chromosome number, is not authorised. IVF with PGT-A should therefore not be presented as an option available in France for unexplained recurrent miscarriage.

In the context of recurrent miscarriage, targeted preimplantation genetic testing may be considered when a parental structural chromosomal rearrangement, particularly a translocation, has been identified. A specialist team assesses eligibility under French law. Testing is then performed on embryos created through IVF, before transfer.

What about hydroxychloroquine?

Hydroxychloroquine should not be presented as routine treatment for unexplained recurrent miscarriage. The French BBQ trial published in 2026 did not demonstrate a benefit in the population studied. Prescribing it for an autoimmune disease involves a different indication and specialist care.

How can you prepare for another pregnancy?

Care remains valuable even when no cause is identified. Your doctor will discuss the outlook in light of your age, history and assessment, and plan monitoring for a future pregnancy. Psychological support can be offered to both partners. No treatment can guarantee that another miscarriage will not occur.