What to expect at a Recurrent Miscarriage Check-up
Your First Appointment
- Thorough history: timing and pattern of previous losses, symptoms, any early bleeding, medications, and family history.
- Focused pelvic exam (only if helpful and with consent).
- Ultrasound to assess the uterus and ovaries; if needed, we’ll arrange 3D ultrasound or hysteroscopy to check for uterine anomalies.
Targeted Blood Tests
- Antiphospholipid antibodies (lupus anticoagulant, anticardiolipin) are evaluated for APS, a treatable cause in a subset of patients.
- Thyroid function and other tests where clinically indicated. Routine inherited thrombophilia testing isn’t recommended unless there are additional risk factors; we’ll explain when it may be useful.
Planning for a Future Pregnancy
- If you have vaginal bleeding in early pregnancy and at least one previous miscarriage, we’ll discuss vaginal micronised progesterone (typically 400 mg twice daily) up to 16 weeks if a heartbeat is seen—reflecting current NICE recommendations informed by the PRISM trial. We will explain the benefits, limits of the evidence, and when it’s not indicated.
- If antiphospholipid syndrome is diagnosed, we’ll arrange an obstetric plan that may include low-dose aspirin and heparin in pregnancy.
- Lifestyle and preconception support (high-dose folic acid where appropriate, smoking cessation, weight optimisation) are part of your plan.
Why a Specialist Clinic?
UK guidance recognises that evaluation is warranted after three losses and clinicians may begin earlier after two, depending on circumstances, to reduce delays and offer targeted care. Our aim is timely investigation, clear communication, and continuity into early pregnancy.
Frequently asked questions
When is recurrent miscarriage diagnosed?
Recurrent miscarriage is defined as three or more early losses, but many clinicians start investigations after two if there’s concern. We’ll tailor advice to your history.
Which tests are usually recommended?
Pelvic ultrasound (and sometimes 3D ultrasound/hysteroscopy), antiphospholipid antibody testing, and thyroid function are standard. Broader testing is considered case-by-case.
Will progesterone help in my next pregnancy?
NICE recommends vaginal micronised progesterone for women with early pregnancy bleeding and at least one prior miscarriage, continued to 16 weeks if a heartbeat is seen. It’s not routinely advised for women without bleeding. We’ll discuss if it’s right for you.
What if no clear cause is found?
That’s common; even then, many couples go on to have a successful pregnancy. We focus on evidence-based support, close early-pregnancy monitoring, and a plan you understand.
