This is not a checklist you have failed
Most miscarriages have no identified cause, and most people who have one go on to have a healthy pregnancy with no intervention at all. Nothing here implies a loss could have been prevented. It is here because it is easier to ask when you know what to name.
Testing before you try again
US guidelines usually wait for two or three losses. That threshold is about populations, not about whether your loss had a cause. You can ask sooner.
- Thyroid functionTSH and thyroid antibodies.
- Blood sugarHbA1c, particularly if diabetes runs in your family.
- Antiphospholipid antibodiesAmong the few causes with a treatment that has been shown to work.
- The shape of the uterusUsually an ultrasound, looking for fibroids, polyps or a septum.
- Iron studies and vitamin DCheap, and often simply not done.
Testing the pregnancy tissue
This changes what happens next more than anything else here: an abnormal result usually means the loss was not caused by something in your body, and a normal one is what makes further testing worth doing.
- Ask early: before or at the time of a procedureWhether it can be tested at all depends on how it is collected.
- Ask which test they useMicroarray finds more than the older karyotype method, which can also fail on maternal cell contamination.
- Ask what it costs without insuranceCoverage is inconsistent, and the self-pay price is often lower than people expect.
Your own care
- Whether to change any medicationsAnything you take regularly is worth reviewing before conceiving.
- Mental health support optionsAbout one in three women meet the criteria for PTSD after a loss. Ask what is available, and take it if it is offered.
- How long to wait before trying againThe evidence for any particular interval is weaker than the confidence with which it is given. Ask if there is a reason specific to you.
Partner evaluation
Routinely skipped, and the guidance on it changed recently.
- A semen analysis, and what it can actually tell youWorth asking for, but ASRM's 2026 opinion says standard semen analysis does not appear to predict recurrent loss.
- Sperm DNA fragmentation testingA different test, and the one that changed: ASRM now says it may be considered after otherwise unexplained recurrent loss, while noting that whether treating it improves outcomes is still unknown.
ASRM, Recurrent pregnancy loss: a committee opinion (2026) ↗
Our Contributing Factors page goes through the evidence for each of these, including where it is thin. It is written to be readable by someone who is not a clinician, and it is fine to take with you. Contributing Factors →
In progress
Coming: a page to take with you
A printable version of these questions, to hand to a clinician. Not ready yet. If you would use it, tell us; it moves up the list when people ask.
Tell us what would help →