Recurrent Miscarriage in Bangladesh: Why It Happens and How It's Treated

Losing a pregnancy is painful. Losing more than one can feel unbearable — and it often comes with silence, blame and confusion. We want to say two things clearly at the start. First, recurrent miscarriage is not your fault. Second, in most couples a cause can be found and treated, and the great majority go on to have a healthy baby. This guide explains, honestly and gently, why recurrent miscarriage happens, what tests genuinely help, and how it is treated.WHAT COUNTS AS RECURRENT MISCARRIAGE Recurrent miscarriage usually means losing two or more pregnancies. After two losses it is reasonable to seek a specialist assessment rather than waiting — particularly if you are 35 or older, because finding and treating a cause earlier protects your future chances. Seeking help is not giving up; it is taking control. WHY RECURRENT MISCARRIAGE HAPPENS There is rarely a single cause, and sometimes more than one factor is involved. The most common reasons include: - Chromosomal or genetic factors in the developing pregnancy - Problems with the shape or lining of the uterus (such as a septum, fibroids or scar tissue) - Hormonal and metabolic issues, including thyroid disorders, poorly controlled blood sugar and PCOS - Blood-clotting and immune conditions, especially antiphospholipid syndrome - Infections and, in some cases, lifestyle factors Importantly, in a meaningful number of couples no single cause is found — and even then, the outlook for a future successful pregnancy remains good with supportive care. THE TESTS THAT GENUINELY HELP A focused, evidence-based work-up avoids wasting money on tests that do not change treatment. It typically includes: - Blood tests for antiphospholipid antibodies and clotting disorders - Thyroid function and blood sugar (HbA1c) testing - A pelvic ultrasound, and where indicated a hysteroscopy, to examine the uterine cavity - Hormone assessment, including for PCOS and prolactin - In selected couples, genetic (karyotype) testing The aim is simple: find what is treatable, and reassure you about what is not a problem. HOW RECURRENT MISCARRIAGE IS TREATED Treatment is directed at the cause that is found: - Antiphospholipid syndrome is treated with low-dose aspirin and blood-thinning injections (heparin) in pregnancy, which substantially improves live-birth rates. - A uterine septum or scar tissue can often be corrected with a minor hysteroscopic procedure. - Thyroid disorders and blood sugar are corrected before and during pregnancy. - PCOS and hormonal issues are managed to support a healthier pregnancy. - Where no cause is found, supportive early-pregnancy care and close monitoring make a real difference. THE ROLE OF SUPPORTIVE CARE Even when no specific cause is identified, dedicated early-pregnancy support — frequent reassurance scans, prompt access to your doctor, and careful monitoring — is associated with better outcomes. You should never feel you are managing this alone. Emotional support matters too: recurrent loss takes a toll, and it is right to seek and accept help. WHAT YOU CAN DO NOW - Do not wait in silence after a second loss — book an assessment. - Bring records of previous pregnancies and any tests already done. - Optimise the basics before trying again: healthy weight, controlled blood sugar and thyroid, folic acid, and stopping smoking. - Ask your husband to attend — some causes involve both partners. FREQUENTLY ASKED QUESTIONS Is recurrent miscarriage my fault? No. Recurrent miscarriage is a medical condition, not a result of anything you did. Working stairs, normal activity, mild stress and ordinary life do not cause it. Blame helps no one and is not supported by evidence. After two miscarriages, can I still have a healthy baby? Yes. The majority of couples with recurrent miscarriage go on to have a successful pregnancy, especially once a treatable cause is found and managed. When should I see a specialist? After two pregnancy losses it is reasonable to seek a specialist assessment — sooner if you are 35 or older. Earlier evaluation protects your future chances. Will I need IVF? Usually not. Most recurrent miscarriage is treated by correcting the underlying cause, not by IVF. IVF with genetic testing of embryos is considered only in specific situations, such as certain genetic findings. YOU DO NOT HAVE TO FACE THIS ALONE If you have experienced more than one loss, a thorough assessment can find what is treatable and give you a clear, hopeful plan. Prof. Dr. Liza Chowdhury offers compassionate, evidence-based care for recurrent miscarriage at the Uttara Fertility Centre and partner chambers across Dhaka — including Uttara, Kafrul and Cantonment. The next pregnancy deserves every support, and so do you.