After a miscarriage, it's natural to want answers. Most early losses are due to chromosomal abnormalities- not anything you did- but after two or more consecutive miscarriages, doctors often recommend further testing to look for an underlying cause.
Here’s what testing can look like, what it might reveal, and when it’s typically offered.
When Doctors Recommend Testing
After one miscarriage: Usually, testing isn’t done unless there are unusual symptoms or known medical issues.
After two or more miscarriages: Doctors may suggest a recurrent miscarriage workup- including blood, genetic, or imaging tests to look for possible hormonal, immune or structural causes.
After a later loss (second or third trimester): Testing is usually recommended automatically to check for uterine, placental, or medical conditions that could recur.
Common Types of Testing
1. Blood tests
Look for:
Hormone imbalances (thyroid function, progesterone and prolactin.
Autoimmune or clotting disorders (antiphospholipid syndrome, lupus anticoagulant, or inherited thrombophilias).
Chromosomal abnormalities. Karyotyping of both partners may be recommended if a genetic cause is suspected
2. Tissue testing
If tissue from the miscarriage is available, doctors may test for chromosomal changes. This can confirm whether the cause was genetic rather than structural or hormonal.
3. Ultrasound and imaging
Pelvic or 3D ultrasound, hysterosalpingography, or hysteroscopy can assess the uterus for fibroids, septum, or scarring (Asherman's syndrome) that may contribute to recurrent miscarriage.
4. Additional testing
If initial tests are inconclusive, doctors may check for chronic infections (e.g., chlamydia, CMV, gonorrhoea or bacterial vaginosis) or immune-related factors.
What the Results Mean
Even if testing doesn't reveal a clear cause, it doesn't mean hope is lost. Many people go on to have a healthy pregnancy with time, care, and the right support.
Emotional Side
Waiting for test results can be hard. Many describe it as reopening the wound of loss:
“I wanted to know why, but I was terrified of what I might hear.”
It’s okay to ask your provider for emotional support during this stage, too.
Key Takeaways
Most early miscarriages aren't preventable and often result from genetic changes.
Testing is typically offered after two or more consecutive losses or after a late loss.
Results can help guide treatment, such as progesterone support or clotting medications (for Antiphospholipid syndrome).
It’s normal to feel anxious while waiting for answers — you deserve both clarity and compassion.
✨ Sibyl provides medically accurate, trauma-informed guidance — including help understanding what tests might mean and how to navigate them emotionally. Sign up to try an early version of the app here: https://www.sibyl.care/signup
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