Getting pregnant after miscarriage

Experiencing repeated pregnancy loss can be heartbreaking and overwhelming, especially when answers feel hard to come by. Many people who have miscarried more than once wonder whether seeing a fertility specialist could help them confirm what’s going wrong—or improve their chances of a healthy pregnancy.

At Collab Fertility, we provide compassionate, evidence-based care for patients navigating recurrent miscarriage. Through our integrative, whole-person approach, The Collab Way, we support both the medical and emotional aspects of fertility care from day one. 

At Collab, our team is able to identify the cause of recurrent pregnancy loss in approximately 50% of cases. Even when a clear cause isn’t found, empiric treatments can help many patients have a healthy pregnancy and birth.

What is recurrent miscarriage?

A miscarriage occurs when a pregnancy ends naturally before 20 weeks, more often during the first trimester of pregnancy. According to the American Society for Reproductive Medicine (ASRM), approximately 15–25% of clinically recognized pregnancies end in miscarriage. Most single, early pregnancy losses—particularly those occurring before 10 weeks—are caused by chromosomal abnormalities in the embryo, which are associated with increasing female age.

Recurrent pregnancy loss (RPL) is different. While miscarriage itself is common, repeated loss is not. Fewer than 5% of women experience two consecutive miscarriages, and only about 1% experience three or more.

What causes recurrent pregnancy loss?

Recurrent pregnancy loss can have multiple contributing factors, including structural or autoimmune conditions.

Genetic factors:
Early pregnancy losses are often linked to chromosomal abnormalities in the embryo. In 3% of cases, one partner may carry a balanced chromosomal rearrangement that increases the likelihood of recurrent loss. IVF with preimplantation genetic testing for structural rearrangements (PGT-SR) can help identify a healthy embryo, enabling couples to achieve a successful live birth. 

Uterine and structural factors:
The shape or structure of the uterus can affect implantation and early pregnancy development. Conditions such as a uterine septum (a common congenital defect where a wall of tissue divides the uterus into two cavities) or submucosal fibroids (intracavitary fibroids) may increase miscarriage risk. A same-day procedure called Operative hysteroscopy can fix these issues so patients can go on to have healthy pregnancies. 

Underlying medical conditions:
Health issues beyond the reproductive system can also contribute, including thyroid disease, diabetes, hormonal imbalances, autoimmune conditions, and blood-clotting disorders. Antiphospholipid antibody (aPL) syndrome, an acquired autoimmune disease, is one of the most well-established and treatable causes of recurrent miscarriage.

Lifestyle and environmental factors:
Smoking, recreational drug use, heavy alcohol intake, excessive caffeine consumption, and higher body weight have all been associated with an increased risk of miscarriage. Environmental exposures and overall health can also influence early pregnancy development. Studies have found associations between elevated urinary concentrations of BPA and phthalates—chemicals commonly used in plastics and personal care products—and an increased risk of miscarriage. Through our integrative care model, The Collab Way, we help our patients reduce their exposure to these chemicals.

One important factor that deserves special attention is age-related aneuploidy, which plays a significant role in miscarriage risk for many patients over 35 years old.

Is age a factor in miscarriage?

Age can influence miscarriage risk largely because of age-related aneuploidy, a term used to describe embryos with too many or too few chromosomes. As eggs age, the process of cell division becomes less precise, increasing the likelihood that chromosomes do not separate correctly. This can affect early embryo development and implantation and is a common cause of miscarriage, as well as conditions such as trisomy 21 and Down’s Syndrome.

Importantly, approximately 90–95% of chromosomal abnormalities originate in the egg rather than the sperm. Unlike eggs, which are formed before birth and age over time, sperm are produced continuously, with a new cycle every few months, making sperm-related aneuploidy relatively uncommon. For patients under 35, the risk of miscarriage between 6 and 12 weeks of pregnancy is generally estimated to be under 15%. After age 35, miscarriage risk begins to rise, and by age 40 and beyond, more than half of eggs—and therefore many embryos—are estimated to be aneuploid, contributing to miscarriage rates that may approach 50%.

At Collab Fertility, we look beyond age alone. By understanding how age interacts with genetics, overall health, and other contributing factors, we create personalized, evidence-based care plans that support each patient’s path forward.

Is IVF good for recurrent miscarriages

IVF can be helpful for some patients with recurrent pregnancy loss primarily because it allows for preimplantation genetic testing for aneuploidy (PGT-A), genetic testing of embryos before they are transferred to the uterus. This approach can be especially beneficial for patients over age 35 or for those with recurrent miscarriage and an otherwise normal evaluation.

In some couples with recurrent pregnancy loss, genetic testing reveals a balanced chromosomal translocation in one partner. While the carrier is typically healthy, this rearrangement can lead to embryos with missing or extra genetic material, increasing the risk of miscarriage. For these patients, IVF with preimplantation genetic testing for structural rearrangements (PGT-SR) can be especially helpful. PGT-SR allows embryos to be tested before transfer so that only those with a balanced chromosomal makeup are selected, significantly reducing miscarriage risk and improving the chances of a healthy pregnancy.

IVF is not the right solution for every cause of recurrent miscarriage, but when age-related aneuploidy or unexplained pregnancy loss is a contributing factor, IVF with PGT-A can play an important role in supporting successful outcomes.

Reducing miscarriage risk often requires addressing multiple factors, including hormonal balance, inflammation, nutrition, stress, and environmental exposures. At Collab Fertility, every patient receives a comprehensive evaluation and personalized guidance through The Collab Way, which includes nutrition counseling, supplement recommendations, stress-reduction strategies, and clean-living guidelines to help create the healthiest possible environment for pregnancy.

When should you get evaluated for recurrent pregnancy loss?

After two or more pregnancy losses, it’s often time to see a fertility specialist. Targeted testing can play an important role in understanding what may be contributing to repeated miscarriages and in guiding next steps. In approximately half of patients with recurrent pregnancy loss, a likely underlying cause can be identified, many of which are treatable. When a cause isn’t found, empiric treatments can still help many patients achieve healthy live births. Working with a fertility specialist like Dr. Segal at Collab can help reduce the risk of future loss.

To better understand the potential causes of recurrent pregnancy loss, your Collab care team will review your medical history and recommend targeted testing. This evaluation may include one or more of the following:

• Hysteroscopy: A minimally invasive procedure that allows your physician to directly examine the uterine cavity using a thin, lighted scope to identify and treat structural concerns that may affect implantation or pregnancy development.
  
  
• Ultrasound imaging: High-frequency sound waves are used to assess the uterus and surrounding structures for anatomic differences, such as fibroids or uterine shape variations.
  
  
• Hormone testing: Blood tests may be used to evaluate hormone levels, including thyroid hormones, prolactin, and progesterone, which play important roles in early pregnancy.
  
  
• Karyotype testing: A chromosomal analysis that can identify genetic rearrangements or abnormalities in one partner that may increase the risk of recurrent miscarriage.
  
  
• ReceptivaDx: A specialized test that evaluates markers of inflammation and infection in the uterine lining, which may be associated with conditions such as endometriosis. At Collab Fertility, Dr. Thalia Segal uses ReceptivaDx for patients with recurrent pregnancy loss or failed euploid embryo transfers to help uncover underlying factors that are not always visible on routine imaging or standard lab tests. As part of the ReceptivaDx test, an endometrial biopsy is evaluated for CD138, which can indicate chronic endometrial inflammation, and BCL6, a marker associated with endometriosis—both of which may affect implantation and early pregnancy.

How soon can you try IVF after a miscarriage?

IIn most cases, patients can begin IVF after a miscarriage once their menstrual cycle resumes and their doctor has confirmed it is medically safe (when the HCG pregnancy hormone is <5). At Collab, recovery time varies by individual, but many people start treatment within one to two cycles. Emotional readiness is equally important, and our team—including our supportive and compassionate nurses and partner integrative support providers—helps patients move forward when they feel prepared.

The Collab Way: a comprehensive approach to recurrent pregnancy loss

IVF can be an effective option for some patients with recurrent miscarriage, particularly when paired with careful testing, embryo evaluation, and personalized treatment planning. Many Collab patients with a history of pregnancy loss have gone on to achieve successful pregnancies through treatment of underlying causes, and in some cases with the support of IVF and preimplantation genetic testing for aneuploidy (PGT-A).

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Dr. Thalia Segal and the entire team at Collab are known for their warmth, compassion, and commitment to understanding each patient's story. Dr. Segal’s deep expertise and thoughtful, personalized approach have made Collab a leading choice for those seeking fertility care after multiple pregnancy losses. We’re here to support you at every step. Schedule a consultation with our Bay Area fertility specialists to learn how we can help you move forward with confidence.

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