1–2%
Of couples experience recurrent pregnancy loss (3+ miscarriages)
~50%
Of recurrent miscarriages have an identifiable cause
>70%
Of couples with RPL go on to have a successful pregnancy with appropriate care

What Is Recurrent Pregnancy Loss?

Recurrent pregnancy loss (RPL) is defined as three or more pregnancy losses before 20 weeks. Some specialists begin investigating after two losses, particularly if the woman is over 35 or has other risk factors. Each loss is devastating — and each one deserves investigation, not reassurance that it will be fine next time.

Causes of Recurrent Miscarriage

  • Chromosomal abnormalities — most common cause; either embryo-level or parental
  • Antiphospholipid syndrome (APS) — a blood clotting disorder, highly treatable with aspirin and heparin
  • Uterine abnormalities — septum, fibroids, polyps, or Asherman's syndrome
  • Thyroid dysfunction — even subclinical hypothyroidism increases miscarriage risk
  • PMOS and insulin resistance — hormonal and metabolic drivers of early pregnancy loss
  • Progesterone deficiency — insufficient luteal phase support
  • Immunological factors — NK cell activity and implantation failure
  • Male factor — sperm DNA fragmentation is an often-overlooked contributor

Investigations at Petals Clinic

  • Complete hormonal profile — thyroid, prolactin, progesterone, AMH
  • Antiphospholipid antibody testing — lupus anticoagulant, anticardiolipin antibodies
  • Thrombophilia screen — Factor V Leiden, prothrombin mutation
  • Parental karyotype — chromosomal analysis of both partners
  • Pelvic ultrasound and hysteroscopy — uterine anatomy evaluation
  • Sperm DNA fragmentation test — for male partner
  • Immunological assessment where indicated

Treatment & Support

  • Personalised protocol based on identified cause
  • Progesterone supplementation in early pregnancy for luteal phase deficiency
  • Low-dose aspirin and heparin for antiphospholipid syndrome
  • Thyroid optimisation before and during pregnancy
  • Hysteroscopic correction of uterine abnormalities
  • Preimplantation Genetic Testing (PGT-A) with IVF — to select chromosomally normal embryos
  • Emotional support and counselling throughout
You Are Not Alone

Recurrent miscarriage is not your fault. Dr. Juneja approaches every RPL consultation with deep sensitivity — taking the time to fully investigate, explain, and support. Most couples with recurrent pregnancy loss go on to have successful pregnancies with the right care.