Recurrent miscarriage: causes and management

Recurrent miscarriage: causes and management

Recurrent miscarriage (RCC): what is it?

Recurrent miscarriage (RCC) is defined as the occurrence of 3 consecutive 1st-trimester miscarriages (< 14 weeks' gestation) with the same partner.


What causes recurrent miscarriage?

Here is a list of the different causes of recurrent miscarriage: 

  • Diabetes
  • Antiphospholipid syndrome
  • Thyroid problems
  • Vitamin deficiency (B9, B12), hyperhomocysteinemia
  • A pituitary problem: hyperprolactinaemia (Grade B)
  • A uterine malformation or an acquired uterine anomaly accessible to surgical treatment
  • Genetic analysis of the couple (karyotype)


What should be done in the event of a recurrent miscarriage?

1. Progesterone supplementation in the first trimester reduces the risk of recurrent miscarriage in patients with recurrent miscarriages.

2. It is recommended that women with recurrent miscarriages and identified vitamin deficiency(s) be substituted with vitamins B6, B9, or B12.

3. If a cause has been identified, it should be treated: thyroid problem, pituitary anomalies, uterine anomaly, diabetes.

4. In the case of genetic anomalies, pre-implantation diagnosis may be considered.

5. It is recommended to prescribe aspirin + LMWH in women with CRFs and anti-phospholipid syndrome.

6. It is not recommended to prescribe aspirin to prevent the recurrence of unexplained recurrent miscarriages.


Written by:

Dr Vanessa Gallot,
Department of Reproductive Medicine and Fertility Preservation,
Antoine Béclère Hospital

Gynaecological PathologiesMiscarriageLifestylePrevention

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