A miscarriage, defined as the loss of a pregnancy before 20 weeks, is a difficult experience. A common concern following such an event is whether it indicates future infertility. A single miscarriage does not typically mean a person is infertile. The body often recovers physically within weeks, and fertility commonly returns quickly.
Miscarriage and Future Fertility
Most individuals who experience a single miscarriage go on to have successful pregnancies. Research indicates that almost 85% of women achieve a healthy pregnancy after one miscarriage, and about 75% succeed even after two or three. Miscarriages are common, affecting 10% to 25% of all pregnancies, with some occurring before a person even realizes they are pregnant. Many miscarriages, especially in the first trimester, occur due to chromosomal abnormalities or random genetic errors in the developing embryo. These errors are typically spontaneous and do not usually indicate an underlying issue with either parent’s fertility; physical recovery often takes a few hours to a couple of days, with the menstrual cycle usually returning within four to six weeks.
When Miscarriage Might Indicate a Deeper Issue
While a single miscarriage is often a random event, recurrent miscarriage, also known as recurrent pregnancy loss (RPL), can signal an underlying issue. RPL is generally defined as two or more consecutive failed clinical pregnancies, though some medical societies consider it three or more losses. Approximately 1% to 5% of women experience recurrent miscarriages. Recurrent miscarriages warrant further investigation by healthcare professionals to identify potential causes. Even when a cause is found, many individuals with RPL still go on to have successful pregnancies with appropriate management.
Common Causes of Recurrent Miscarriage
Several factors can contribute to recurrent miscarriage:
Genetic or chromosomal abnormalities in either parent, such as balanced translocations, are found in about 2% to 8% of couples with RPL. These can lead to an embryo with an incorrect amount of genetic material.
Anatomical issues with the uterus, such as a septate uterus (a wall of tissue dividing the uterine cavity), fibroids, or polyps, can interfere with implantation or pregnancy progression. These uterine anomalies are present in about 10% to 20% of RPL cases.
Hormonal imbalances, including uncontrolled thyroid disease, diabetes, or polycystic ovary syndrome (PCOS), can affect the uterine lining and embryo development.
Immunological factors, such as antiphospholipid syndrome (APS), account for 7% to 25% of recurrent miscarriages. APS is an autoimmune disorder that increases blood clotting, which can hinder proper placental function.
Lifestyle factors, including being underweight or overweight, smoking, and excessive alcohol consumption, may also contribute to recurrent miscarriage risk.
In approximately 50% of RPL cases, no specific cause is identified.
Pathways to Future Pregnancy
Individuals who have experienced a miscarriage, especially those over 35 or who have had two or more miscarriages, should consider consulting a healthcare professional. A medical evaluation for recurrent miscarriage often involves blood tests to check for hormonal or immunological issues and imaging studies to assess uterine structure. Genetic testing, such as a karyotype, may also be recommended for both partners. Optimizing chances for a future pregnancy involves maintaining a healthy lifestyle, which includes a balanced diet, regular exercise, and managing any chronic conditions. Taking prenatal vitamins, particularly folic acid, is also advised. Allowing for physical and emotional recovery and following a doctor’s guidance regarding the optimal time to try again is beneficial. Most individuals who experience miscarriage ultimately achieve a successful pregnancy.