What to Do About Recurrent Miscarriage? Key Tests Before Mexico Surrogacy

For people who have experienced one miscarriage, the next pregnancy often comes with greater anticipation, but it may also bring stronger anxiety. When miscarriages happen repeatedly, many intended parents begin to reconsider: Which part of the process could be causing the problem? Is it the embryo itself, genetic factors, or the uterine environment affecting the pregnancy?

What Should Be Checked First for Recurrent Miscarriage?

In medical practice, two or more pregnancy losses are generally considered recurrent pregnancy loss (RPL), after which further evaluation may be considered. The American Society for Reproductive Medicine’s updated 2026 guidance points out that evaluation should not simply repeat basic tests, but should instead look for possible causes based on previous pregnancy losses.

Among these, chromosome testing of the embryo or pregnancy tissue has received increasing attention. A significant proportion of early miscarriages are associated with chromosomal abnormalities in the embryo. Therefore, when possible, genetic analysis of pregnancy tissue can help determine whether a miscarriage was associated with an embryonic chromosomal abnormality and may also provide clues for further evaluation.

What Other Factors Should Be Considered Besides Embryonic Factors?

Recurrent miscarriage does not have only one cause. Doctors will usually also evaluate the structure of the uterus based on medical history, including conditions such as a uterine septum, intrauterine adhesions, and some fibroids or polyps. When necessary, ultrasound, uterine imaging, or other examinations may be used to further assess the uterine environment. ASRM currently recommends evaluating the uterine cavity in people with recurrent pregnancy loss to identify anatomical factors that may affect pregnancy.

At the same time, certain systemic factors may need to be considered depending on the individual situation. For example, antiphospholipid syndrome, thyroid disorders, and abnormal glucose metabolism may all be associated with the risk of pregnancy loss. Not everyone needs to undergo every possible test. What matters is conducting a targeted evaluation based on medical history, age, the timing of previous miscarriages, and existing test results.

If a clear structural abnormality of the uterus is identified, appropriate treatment may improve the conditions for pregnancy in some cases. If testing indicates a specific condition such as antiphospholipid syndrome, appropriate management of the underlying condition is needed. For families with certain genetic concerns, genetic counseling may also be appropriate, along with further planning based on IVF and embryonic genetic testing. If the problem is related to the uterine environment or an inability to safely carry a pregnancy, surrogacy may be an option.

If recurrent miscarriage is associated with embryonic chromosomal abnormalities, or if the family has already entered the IVF planning stage, they may further explore embryo culture and IVF-PGT. IVF-PGT can provide certain chromosomal and specific genetic information before embryo transfer, helping doctors and families evaluate embryos.

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