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Priyadatt Patel: Recurrent Pregnancy Loss Should Be Assessed After 2 Losses
Priyadatt Patel/balajihorizon.com
Aug 7, 2026, 13:26

Priyadatt Patel: Recurrent Pregnancy Loss Should Be Assessed After 2 Losses

Priyadatt Patel, Senior Gynecologist, Advanced Laparoscopic Surgeon, IVF and Endometriosis Programme Lead at Balaji Horizon Women’s Hospital, shared on LinkedIn:

“Being told to wait until you have lost three pregnancies before anyone will investigate is one of the harder things a couple can hear. That threshold has changed – and it’s worth knowing.

International guidance (ESHRE, 2023) now defines recurrent pregnancy loss as two or more losses, and supports beginning a structured assessment after two – not necessarily consecutive. Earlier, kinder, and more useful than waiting for a third.

A considered evaluation looks for the genuinely treatable things, or that change the plan: a clotting condition (antiphospholipid syndrome), thyroid and other hormonal factors, the shape of the uterus, and – a more recent addition to the guideline – adenomyosis. Genetic factors are weighed where relevant.

Two honest points matter as much as the tests themselves.

First, even after a complete, careful work-up, around half of recurrent losses have no identified cause. That is not a failure of testing – and ‘unexplained’  is not the same as ‘untreatable’ or ‘hopeless.’ For many couples in this group, the outlook for a future successful pregnancy is better than the fear suggests.

Second, more testing is not automatically better care. Many add-on investigations and immune ‘treatments’ marketed for miscarriage are not supported by good evidence, and ESHRE specifically advises against several of them. Where treatment does help, it is targeted: vaginal progesterone improves live-birth rates specifically for women who have both previous miscarriage(s) and current early-pregnancy bleeding – not for everyone.

Good care for recurrent loss is measured, evidence-based and honest: it investigates what is worth investigating, treats what is genuinely treatable, and offers realistic hope rather than a long list of unproven add-ons.

If you have had two or more losses, it is reasonable to ask for a structured assessment – and, of any test or treatment offered, to ask what the evidence actually shows.”

Priyadatt Patel: Recurrent Pregnancy Loss Should Be Assessed After 2 Losses

Stay informed with the latest updates in fertility and reproductive medicine on Fertility News.

adenomyosis Antiphospholipid Syndrome ESHRE Fertility Fertility News OBGYN pregnancy loss Priyadatt Patel Recurrent Pregnancy Loss reproductive health Reproductive Medicine Women’s Health
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