Recurrent pregnancy loss (RPL) is usually defined as two or more pregnancy losses. This is the point where doctors stop treating early losses as a one-off chance event and start a structured evaluation. Many couples have a cause that can be found and treated.
What counts as recurrent pregnancy loss
A single early miscarriage is common and most often due to a chance chromosomal error in that embryo — it typically says nothing about your future chances. Two or more losses is the point where a formal workup is worth doing, rather than being told to simply try again. Some clinics evaluate after two losses, others wait for three. In most definitions, the losses don't have to be back to back — they still count toward the pattern even if there was a live birth in between.
What the evaluation investigates
Testing typically covers:
- Chromosomal factors in both partners — if either carries a balanced chromosomal rearrangement, PGT-SR on future embryos may be discussed.
- The shape of the uterine cavity — fibroids, polyps, or a septum, often checked directly with a hysteroscopy when a scan alone isn't conclusive.
- Hormonal and metabolic factors — thyroid function, diabetes, prolactin.
- Clotting and immune conditions — such as antiphospholipid syndrome.
- Infection, where relevant to history.
Both partners are evaluated — this is never a one-person diagnosis.
When it's raised
RPL evaluation comes up after the second or third loss, not after a single miscarriage. It is often discussed alongside recurrent implantation failure if you've also had IVF transfers that didn't implant at all. The two are related but different, and share some of the same tests.
The outlook
In a large share of couples, no cause is found. Even then, the chance of a successful next pregnancy remains good with supportive care and close monitoring in early pregnancy. The right response to repeated loss is a plan, not just hope.
For the full evaluation — what each test actually checks, what happens once a cause is found, and the honest outlook when none is — see the complete guide to recurrent pregnancy loss.
Frequently asked
What is recurrent pregnancy loss?
It's generally defined as two or more pregnancy losses. This pattern calls for a proper medical evaluation rather than being treated as a run of bad luck, because many couples have a cause that can be found and treated.
How many miscarriages before it's called recurrent pregnancy loss?
Most definitions use two or more losses as the threshold, though some clinics evaluate after two and others after three. The exact count matters less than recognising that a pattern of losses, rather than one isolated miscarriage, calls for testing.
Can recurrent pregnancy loss be treated?
Treatment depends on what the evaluation finds — correcting a thyroid or hormonal imbalance, addressing a uterine cavity issue, or managing a clotting condition, for example. Even when no specific cause is identified, supportive care and closer early-pregnancy monitoring improve the outlook for the next pregnancy.