Recurrent miscarriage, also called recurrent pregnancy loss (RPL), is defined as two or more consecutive pregnancy losses before 20 weeks gestation.¹ It affects approximately 1-2% of couples trying to conceive and is one of the most emotionally devastating experiences in reproductive medicine. Unlike a single miscarriage, which occurs in approximately 10-20% of recognized pregnancies and is most often a random chromosomal event, recurrent loss implies an underlying cause that warrants systematic investigation.

The distinction between recurrent miscarriage and a single loss is clinically important because it changes what should be investigated and treated. Most couples experiencing recurrent miscarriage have never had a comprehensive workup – standard obstetric care after two or three losses typically includes only karyotyping, uterine imaging, and antiphospholipid antibody testing. A thorough naturopathic assessment goes considerably further.

This page focuses specifically on recurrent pregnancy loss. For information on a single miscarriage or on implantation failure, see the miscarriage page → and implantation failure page →.

The Emotional Reality First

Before the clinical content: recurrent miscarriage is grief, not just a medical problem. Each loss is the loss of a pregnancy, a future child, and frequently a significant amount of hope. The experience of being told “your tests are normal, just keep trying” after multiple losses – which is distressingly common – is dismissive of both the clinical complexity and the emotional weight of what couples are carrying.

My approach takes recurrent miscarriage (and single miscarriage) seriously as both a diagnostic and a human problem. There is almost always something investigable and frequently something treatable. Finding it requires a level of workup thoroughness that standard care doesn’t consistently provide.

How Common Is Recurrent Miscarriage and What Are the Odds of Success?

Approximately 50–75% of couples with recurrent miscarriage will go on to have a successful pregnancy, even without specific treatment – a statistic that is both reassuring and incomplete, because it includes couples with treatable causes who succeed after treatment and couples who were never investigated.² The goal of the investigation is to move from passive hope into active identification and correction of whatever is driving the losses.

Age matters significantly. The risk of chromosomal miscarriage increases with maternal age – from approximately 10% of recognized pregnancies in women under 30 to over 40% in women over 40 – which is why age is always considered alongside other causes rather than in isolation.

Causes of Recurrent Miscarriage

Embryo and Genetic Factors

Chromosomal aneuploidy:

Chromosomal abnormalities are the most common cause of individual pregnancy loss and remains a significant contributor to recurrent miscarriage, particularly in women over 35. In most cases the chromosomal abnormality is a random error in meiosis – a de novo event – rather than an inherited parental chromosomal abnormality. However, approximately 2–5% of couples with recurrent miscarriage carry a balanced chromosomal translocation in one partner that increases the probability of producing aneuploid embryos.³ Parental karyotyping is indicated in recurrent miscarriage workup for this reason. Naturopathic doctors in Ontario cannot order this test.

Sperm DNA fragmentation:

DNA fragmentation contributes to embryo quality and early pregnancy loss independently of maternal factors. Paternal DNA integrity determines half of the embryo’s chromosomal complement. Elevated sperm DNA fragmentation index (DFI) is associated with increased miscarriage rates after both natural conception and IVF, and is not captured by standard semen analysis.⁴ This is consistently underinvestigated in recurrent miscarriage workup. Naturopathic doctors in Ontario cannot order this test.

Oxidative stress in both partners:

drives DNA damage in both oocytes and sperm, contributing to chromosomal abnormalities in the resulting embryo. Oxidative stress is the most modifiable contributor to embryo chromosomal quality and is directly addressable through antioxidant therapy and lifestyle intervention.

Anatomical Factors

Uterine structural abnormalities

Uterine abnormalities, including uterine septum, submucosal fibroids, intrauterine adhesions (Asherman’s syndrome), and endometrial polyps, impair implantation and early placentation by mechanically disrupting the endometrial environment. A uterine septum is the most clearly associated structural abnormality with recurrent miscarriage, with studies reporting miscarriage rates of up to 65% in women with a complete septum before surgical correction.⁵ These are diagnosed by 3D ultrasound, saline infusion sonohysterography, or hysteroscopy and require surgical management – not naturopathic intervention.

Asherman’s syndrome:

Intrauterine adhesions from prior D&C procedures – including those performed after previous miscarriages – can themselves cause subsequent pregnancy losses by disrupting the basal layer of the endometrium and impairing normal placentation. This is a medical diagnosis requiring hysteroscopic lysis of adhesions.

Immunological Factors

Antiphospholipid syndrome (APS):

Antiphospholipid syndrome is the most clearly established and most treatable immunological cause of recurrent miscarriage. Antiphospholipid antibodies – including lupus anticoagulant, anticardiolipin antibodies (IgG and IgM), and anti-β2 glycoprotein I antibodies – cause microvascular thrombosis in placental vasculature, impairing trophoblast invasion and early placentation. APS is present in approximately 15–20% of women with recurrent miscarriage and requires a positive test on two occasions at least 12 weeks apart for diagnosis.⁶ Treatment with low-dose aspirin and low-molecular-weight heparin substantially improves live birth rates in confirmed APS – this is one of the most evidence-supported interventions in recurrent pregnancy loss and requires medical doctor testing and management.

Inherited thrombophilias:

Factor V Leiden, the prothrombin gene mutation G20210A, protein C deficiency, protein S deficiency, and antithrombin III deficiency can impair uteroplacental circulation through mechanisms similar to those of APS. The evidence for treating inherited thrombophilia specifically to prevent miscarriage is less definitive than for APS, but testing is warranted in women with recurrent second-trimester losses in particular, where thrombotic mechanisms are more likely to be operative.⁷ Naturopathic doctors in Ontario cannot order this test.

Thyroid autoimmunity:

Anti-thyroid antibodies – anti-TPO and anti-thyroglobulin – are found in approximately 17–33% of women with recurrent miscarriage, a significantly higher prevalence than in the general population.⁸ The mechanism involves immune dysregulation at the maternal-fetal interface rather than thyroid hormone insufficiency alone: women with positive thyroid antibodies and normal TSH still have elevated miscarriage risk. This is one of the most clinically actionable immunological findings in recurrent miscarriage because it is frequently missed in standard workup and is modifiable through nutritional intervention. Naturopathic doctors in Ontario can order these tests.

Elevated uterine natural killer (uNK) cell activity:

Natural killer cells in the uterine lining play an essential role in early placentation, but in elevated numbers or with dysregulated activity, they can attack trophoblast cells during implantation. Elevated peripheral blood NK cell activity and elevated uterine NK cell density on endometrial biopsy have been reported in women with recurrent miscarriage at higher rates than in fertile controls, though the evidence base for specific treatments remains evolving.⁹ Referral to a reproductive immunologist is appropriate when other causes have been excluded. Naturopathic doctors in Ontario cannot order this test.

Alloimmune factors:

The maternal immune system must develop tolerance to paternal antigens expressed on the embryo – a process involving regulatory T cells, HLA compatibility, and local immune signalling in the uterus. Impaired maternal immune tolerance to paternal antigens is a proposed mechanism in unexplained recurrent miscarriage, though clinical testing and treatment remain investigational rather than established practice.

Endocrine Factors

Thyroid dysfunction:

Both overt and subclinical hypothyroidism are associated with increased miscarriage risk. The TSH target for women who are pregnant or actively trying to conceive is below 2.5 mIU/L – substantially lower than the standard laboratory reference range upper limit of 4.0–5.0 mIU/L used by most Ontario labs. Women with TSH between 2.5 and 4.0 mIU/L who experience recurrent miscarriage should have thyroid function fully tested and optimized before their next conception attempt, in collaboration with their physician where thyroid hormone therapy is indicated.

Luteal phase insufficiency:

Adequate progesterone during the luteal phase is essential for decidualization of the endometrium, implantation, and maintenance of the early pregnancy until the placenta assumes progesterone production at approximately 8–10 weeks (the luteal-placental shift). Low luteal phase progesterone – measured as serum progesterone seven days post-ovulation, with a target above 50 nmol/L in a natural cycle – is a directly addressable cause of early pregnancy loss. Luteal phase defect can result from poor follicular development, hyperprolactinemia, thyroid dysfunction, or inadequate LH-driven corpus luteum function.

Hyperprolactinemia:

Elevated prolactin – including subclinical elevations below standard laboratory flagging thresholds – suppresses LH pulsatility and impairs corpus luteum function, reducing luteal phase progesterone and increasing early pregnancy loss risk. Prolactin is physiologically elevated by stress, and the blood sample should be drawn after 20 minutes of seated rest.

Insulin resistance and PCOS:

Women with PCOS have a significantly higher rate of miscarriage than the general population – estimated at 30–50% per pregnancy in some studies – driven by multiple mechanisms including hyperinsulinemia, elevated androgens, elevated LH relative to FSH, oxidative stress, and endometrial immune dysregulation.¹⁰ Insulin resistance can be present in lean or overweight women without a formal PCOS diagnosis and contributes to miscarriage risk through overlapping mechanisms. Correcting insulin resistance before and during early pregnancy is directly relevant to pregnancy maintenance.

Uncontrolled diabetes:

Both type 1 and type 2 diabetes are associated with substantially increased miscarriage risk, primarily through glycation-related placental damage and oxidative stress. HbA1c above 6.5% at the time of conception is associated with significantly elevated miscarriage rates; optimal pre-conception glycemic control substantially reduces this risk.

Nutritional and Metabolic Factors

MTHFR polymorphisms and homocysteine elevation:

Impaired methylation – identified either through MTHFR genotyping (C677T and A1298C polymorphisms) or through elevated homocysteine – is associated with both recurrent miscarriage and neural tube defects. Homocysteine impairs trophoblast function and early placentation through direct cytotoxic effects on placental vasculature. Women with elevated homocysteine require methylated B vitamins – 5-methyltetrahydrofolate (5-MTHF) rather than folic acid, methylcobalamin rather than cyanocobalamin – regardless of MTHFR genotype.¹¹ Naturopathic doctors in Ontario cannot order genetic testing, like MTHFR testing, but can order blood homocysteine levels.

Vitamin D deficiency:

Vitamin D has direct roles in endometrial immune regulation, trophoblast invasion, and early placentation. Deficiency is endemic in Ontario given our latitude and is independently associated with increased miscarriage risk. A 2019 prospective cohort study found that women with sufficient vitamin D levels (above 75 nmol/L) in early pregnancy had significantly lower rates of miscarriage compared to vitamin D-deficient women.¹²

Celiac disease:

Undiagnosed celiac disease is associated with recurrent miscarriage through nutrient malabsorption (iron, folate, zinc, vitamin D – all directly relevant to pregnancy maintenance), systemic immune dysregulation, and possible cross-reactivity between anti-tTG antibodies and placental tissue. A 2022 systematic review confirmed that untreated celiac disease carries significantly elevated rates of adverse reproductive outcomes including miscarriage, and that adherence to a strict gluten-free diet substantially reduces these risks.¹³ Testing – anti-tTG IgA and total IgA – is a simple blood test that is not routinely ordered in recurrent miscarriage workup but is clinically important, particularly in women with iron deficiency resistant to supplementation or with first-degree relatives with celiac disease. Ontario naturopaths can order celiac testing.

What A Fertility Naturopath Investigates That A Standard Workup Misses

Standard recurrent miscarriage investigation through an obstetric or reproductive medicine clinic typically covers: parental karyotyping, antiphospholipid antibody panel, uterine imaging (ultrasound or hysteroscopy), and TSH. What is rarely investigated:

Full thyroid panel including, free T3, free T4, reverse T3, anti-TPO and anti-thyroglobulin antibodies:

TSH alone misses thyroid autoimmunity, which is present in 17–33% of women with recurrent miscarriage and is independently associated with pregnancy loss even when TSH is normal.

Fasting insulin and HOMA-IR:

Not ordered in standard workup despite the well-established association between insulin resistance, PCOS, and elevated miscarriage rates.

Homocysteine:

A direct functional marker of methylation status. More clinically informative than MTHFR genotype alone because it captures the net effect of multiple methylation pathway inputs. Elevated homocysteine above 10 μmol/L warrants treatment regardless of MTHFR status.

Vitamin D (25-OH):

Not routinely measured in recurrent miscarriage workup despite the direct role of vitamin D in endometrial immune regulation and early placentation. Widely deficient in Ontario.

Day 21 progesterone:

Suboptimal luteal progesterone is a directly addressable cause of early pregnancy loss that is frequently not measured in standard workup. A single measurement seven days post-ovulation provides critical information about luteal phase progesterone levels.

Prolactin:

Subclinical hyperprolactinemia. Prolactin levels may be below standard laboratory flagging thresholds, but still be sufficient to impair corpus luteum function and increase early pregnancy loss risk.

Anti-tTG IgA and total IgA:

Celiac disease screening is not standard in recurrent miscarriage workup despite the documented association between Celiac disease and recurrent pregnancy loss (RPL).

Ferritin:

Iron deficiency below 30 mcg/L, even with a normal hemoglobin, impairs early placentation by reducing oxygen delivery and altering trophoblast function.

Naturopathic Treatment for Recurrent Miscarriage (Recurrent Pregnancy Loss/RPL)

Treatment is matched to the causes identified in the workup. The following are the primary evidence-informed interventions for the modifiable contributors to recurrent pregnancy loss.

Antioxidant Therapy for Oxidative Stress and Embryo Quality

Oxidative stress is the most consistently identified modifiable mechanism in recurrent miscarriage, operating through DNA damage in both oocytes and sperm, placental oxidative injury, and impaired trophoblast function. A comprehensive antioxidant protocol addresses this across both partners:

CoQ10 (ubiquinol, 200–600 mg/day):

Supports mitochondrial integrity in oocytes and reduces oxidative DNA damage. The mitochondrial dysfunction that drives chromosomally abnormal eggs – the most common cause of miscarriage – is directly targeted by CoQ10 supplementation. The ubiquinol form is preferred for bioavailability, particularly in women over 35.¹⁴

Vitamin E (mixed tocopherols, 400–800 IU/day):

Vitamin E is a fat-soluble antioxidant that protects cell membranes from lipid peroxidation in both oocytes and placental tissue and also improves uterine blood flow through nitric oxide-dependent mechanisms.

Vitamin C (500–1000 mg/day):

Vitamin C is a water-soluble antioxidant that works synergistically with vitamin E and supports collagen synthesis, which is relevant to placental vascular integrity.

N-acetylcysteine (NAC, 600 mg/day):

NAC is a glutathione precursor. It supports both oocyte quality and endometrial receptivity; it has specific evidence in women with PCOS, where it has been shown to reduce miscarriage rates in combination with folic acid.¹⁵

Selenium (200 mcg/day as selenomethionine):

Selenium acts as both a direct antioxidant and a cofactor for glutathione peroxidase. Selenium deficiency is associated with thyroid autoimmunity, and selenium supplementation reduces anti-TPO antibody titers in randomized controlled trials – making it doubly relevant in women with thyroid autoimmunity and recurrent miscarriage.¹⁶

Zinc:

Zinc is essential for DNA repair mechanisms in both sperm and oocytes; it supports progesterone synthesis; and deficiency is common and associated with an elevated risk of miscarriage.

For male partners specifically, the antioxidant protocol targets sperm DNA fragmentation – see the male infertility page → for details. Both partners should begin antioxidant support at least three months before the next conception attempt.

Thyroid Optimization and Autoimmunity Reduction

Selenium (200 mcg/day):

The most evidence-supported nutritional intervention for reducing thyroid antibody titers. A 2019 systematic review of 16 RCTs confirmed that selenium supplementation significantly reduced anti-TPO antibody levels in women with Hashimoto’s thyroiditis.¹⁶

Ensuring TSH is below 2.5 mIU/L:

In women whose TSH is between 2.5 and 4.0 mIU/L with recurrent miscarriage, discussion with their physician about low-dose thyroid hormone supplementation is warranted. This falls outside naturopathic prescribing scope in Ontario, but I can and do help reduce TSH by addressing the root cause of thyroid dysfunction.

Inositol:

Myo-inositol combined with selenium has emerging evidence for reducing TSH and thyroid antibodies in women with Hashimoto’s who are euthyroid, through its role in TSH receptor signalling.¹⁷

Anti-inflammatory diet:

Reducing dietary drivers of systemic inflammation, such as ultra-processed foods, refined seed oils, high-glycemic carbohydrates, and excess alcohol, reduces the inflammatory substrate that sustains autoimmune thyroid activity.

Correcting Luteal Phase Insufficiency

Vitex agnus-castus (chaste tree berry):

Acts on dopaminergic D2 receptors in the pituitary to reduce prolactin secretion and improve LH-driven progesterone production in the luteal phase. Has the most consistent evidence base among herbs for luteal phase support and is particularly relevant when suboptimal day 21 progesterone is identified alongside elevated or high-normal prolactin.¹⁸

Vitamin B6 (pyridoxal-5-phosphate, 30–50 mg/day):

Supports progesterone synthesis and has historical evidence for luteal phase support in women with recurrent miscarriage; the active P5P form is preferred over pyridoxine hydrochloride.

Magnesium glycinate or bisglycinate:

Magnesium deficiency impairs steroidogenesis and is associated with elevated miscarriage risk; it is also one of the most commonly deficient minerals in the standard North American diet.

Addressing underlying causes of luteal deficiency:

Low progesterone is often downstream of poor follicular development, hyperprolactinemia, thyroid dysfunction, insulin resistance, and/or androgen excess; correcting the upstream driver is more sustainable than addressing progesterone in isolation.

Methylation Support

Women with elevated homocysteine or confirmed MTHFR polymorphisms require:

5-methyltetrahydrofolate (5-MTHF)

5-MTHF is the active form of folic acid and should always be used rather than folic acid. Women with the C677T homozygous MTHFR variant have approximately 70% reduced MTHFR enzyme activity and cannot adequately convert folic acid to its active form. They may appear to be meeting folate requirements while remaining metabolically deficient.

Methylcobalamin (B12)

MethylB12 should be used rather than cyanocobalamin – the methylated form bypasses the conversion steps that are impaired in methylation dysfunction.

Pyridoxal-5-phosphate (B6)

P5P is the active form of B6, a cofactor in the remethylation cycle and a cofactor for hundreds of different reactions in your body.

Betaine (trimethylglycine)

TMG provides an alternative methylation pathway via betaine-homocysteine methyltransferase, which is particularly relevant when homocysteine is significantly elevated.

The target is homocysteine below 10 μmol/L in women trying to conceive. Repeat testing at 6–8 weeks after initiating methylation support provides objective evidence of response.

Correcting Insulin Resistance

Dietary modification:

Low-glycemic-index, low-glycemic-load, high-fibre, adequate protein, reduced carbohydrate. This is the most effective non-pharmacological intervention for insulin resistance and directly addresses one of the most modifiable drivers of PCOS-associated miscarriage.

Myo-inositol (2g myo + 50 mg D-chiro-inositol, twice daily):

Improves insulin sensitivity, reduces androgens, and supports oocyte quality in women with PCOS. Multiple RCTs have demonstrated reductions in miscarriage rates in PCOS women treated with inositol compared to controls.¹⁰

NAC (600 mg/day):

Reduces insulin resistance through antioxidant mechanisms and has specific evidence in PCOS for improving insulin sensitivity and reducing miscarriage rates in combination with folic acid.¹⁵

Berberine (500 mg three times daily):

Has comparable insulin-sensitizing effects to metformin in clinical trials and is relevant where metformin has not been prescribed or is poorly tolerated. Should not be taken during pregnancy; appropriate for pre-conception optimization only.

Optimizing Vitamin D

Target serum 25-OH vitamin D of 100–150 nmol/L before conception. Most women in Ontario require 2,000–4,000 IU/day to maintain optimal levels; correction of significant deficiency may require higher doses short-term under monitoring. Vitamin D testing and supplementation are among the simplest and most impactful interventions available in recurrent miscarriage care.

Celiac Disease – Dietary Management

Where celiac disease is confirmed, a strict gluten-free diet is the treatment. The key word is strict – partial compliance produces partial improvement in intestinal permeability and immune dysregulation without achieving the full restoration of normal reproductive outcomes associated with complete adherence.¹³ Nutritional repletion of the deficiencies commonly caused by celiac-related malabsorption – iron, folate, zinc, vitamin D, B12 – is an integral part of management alongside dietary change.

What Low-Dose Aspirin Contributes

Low-dose aspirin (81 mg/day) is a cornerstone of medical treatment for APS-associated recurrent miscarriage, where it is used alongside low-molecular-weight heparin under physician management. Outside of confirmed APS, aspirin is used adjunctively to support uterine and placental perfusion through its effects on thromboxane A2-mediated vasoconstriction. Its use during early pregnancy should be discussed with the managing physician.

What Requires Medical Referral In Recurrent Miscarriage

Several causes of recurrent miscarriage require medical management outside naturopathic scope:

Confirmed APS: Low-molecular-weight heparin and aspirin managed by a hematologist or maternal-fetal medicine specialist.

Uterine structural abnormalities: Hysteroscopic surgery for septum resection, adhesion lysis, or polyp/fibroid removal.

Parental chromosomal translocation: Genetic counselling and consideration of PGT-SR (preimplantation genetic testing for structural rearrangements) within an IVF cycle.

TSH above 2.5 mIU/L: Thyroid hormone therapy managed by the patient’s physician or endocrinologist.

Uncontrolled diabetes or HbA1c above 6.5%: Medical glycemic management before and during early pregnancy.

Elevated uNK cell activity: Reproductive immunology consultation.

In all of these situations, I can work alongside the relevant specialist, optimize the modifiable nutritional and metabolic contributors, and coordinate care.

The Three-Month Preparation Window Before the Next Pregnancy

After a miscarriage – and particularly after recurrent losses – beginning the next conception attempt before the body has had adequate time and nutritional repletion to recover is clinically counterproductive. The full oocyte maturation cycle takes approximately 90 days. Sperm DNA fragmentation, if elevated, takes a minimum of 72–74 days of antioxidant treatment to show meaningful improvement on repeat testing.

A minimum three-month preparation window before the next conception attempt allows:

Full antioxidant repletion at the cellular level in both partners
Normalization of methylation status and homocysteine if elevated
Correction of vitamin D, ferritin, and other nutritional deficiencies
Reduction of thyroid antibody titers with selenium
Improvement of luteal phase adequacy
Stabilization of insulin sensitivity

This is not a reason to delay indefinitely – it is a reason to use the time between pregnancies productively rather than passively. Look at it as an investment in a better outcome, rather than time “wasted.”

Frequently Asked Questions About Recurrent Miscarriage

How many miscarriages before investigation is recommended?

Current guidelines from the European Society of Human Reproduction and Embryology (ESHRE) recommend investigation after two pregnancy losses rather than three, recognizing that waiting for a third loss before investigating adds both time and emotional burden without clinical benefit.¹ Many clinicians still follow the older threshold of three losses; if you have had two consecutive miscarriages and have not had a thorough workup, it is reasonable to request one.

What is the most common cause of recurrent miscarriage?

Chromosomal aneuploidy in the embryo is the most common cause of individual miscarriage and a significant contributor to recurrent loss, particularly in women over 35. However, in couples with recurrent miscarriage, treatable causes – including antiphospholipid syndrome, thyroid autoimmunity, luteal phase deficiency, insulin resistance, oxidative stress, hormone imbalance, methylation impairment, and sperm DNA fragmentation – are found in a substantial proportion of cases when a thorough workup is conducted.

Can naturopathic treatment prevent miscarriage?

Where a modifiable contributing cause is identified – oxidative stress, thyroid autoimmunity, luteal phase insufficiency, vitamin D deficiency, insulin resistance, elevated homocysteine, hormone imbalance, celiac disease – addressing it creates a more optimal environment for embryo development and early placentation. Naturopathic treatment is not appropriate for structural uterine abnormalities, confirmed APS, parental chromosomal translocations, or random chromosomal events in embryos, all of which require medical management or simply reflect the probability of aneuploidy in older oocytes.

Should my partner be investigated too?

Yes. Sperm DNA fragmentation is an underinvestigated contributor to both miscarriage and embryo quality that is not captured by standard semen analysis. In couples with recurrent miscarriage where female-factor causes have been investigated without a clear explanation, sperm DNA fragmentation index testing is clinically appropriate. Both partners benefit from antioxidant support during the preparation period before the next attempt at conception.

How long should I wait to try again after a miscarriage?

Most clinical guidelines recommend waiting until after one normal menstrual cycle before resuming physical activity. The naturopathic recommendation is a minimum of three months of active preparation – not passive waiting, but targeted nutritional optimization, antioxidant loading, and correction of identified deficiencies – before the next attempt. This aligns treatment timing with the full oocyte and sperm maturation cycles.

Will naturopathic treatment work if my miscarriages were due to chromosomal abnormalities?

If chromosomal abnormalities in the embryo are driven by high oxidative stress in oocytes or sperm – which is a significant contributor to meiotic errors – antioxidant therapy may reduce the rate of aneuploidy in subsequent cycles. If chromosomal loss is due to a parental structural chromosomal rearrangement or simply reflects the age-related increase in random meiotic error, naturopathic intervention cannot prevent chromosomal abnormalities. The distinction between these mechanisms is part of what a thorough workup helps to clarify.

Research References for Recurrent Miscarriage

ESHRE Guideline Group on RPL; Bender Atik R, Christiansen OB, Elson J, Kolte AM, Lewis S, Middeldorp S, Mcheik S, Peramo B, Quenby S, Nielsen HS, van der Hoorn ML, Vermeulen N, Goddijn M. ESHRE guideline: recurrent pregnancy loss: an update in 2022. Hum Reprod Open. 2023 Mar 2;2023(1):hoad002. doi: 10.1093/hropen/hoad002. PMID: 36873081; PMCID: PMC9982362.
Jauniaux E, et al. Evidence-based guidelines for the investigation and medical treatment of recurrent miscarriage. Hum Reprod. 2006;21(9):2216–2222. PMID: 16775193
Franssen MT, Korevaar JC, van der Veen F, Leschot NJ, Bossuyt PM, Goddijn M. Reproductive outcome after chromosome analysis in couples with two or more miscarriages: index [corrected]-control study. BMJ. 2006 Apr 1;332(7544):759-63. doi: 10.1136/bmj.38735.459144.2F. Epub 2006 Feb 22. Erratum in: BMJ. 2006 Apr 29;332(7548):1012. PMID: 16495333; PMCID: PMC1420685.
Tan J, Taskin O, Albert A, Bedaiwy MA. Association between sperm DNA fragmentation and idiopathic recurrent pregnancy loss: a systematic review and meta-analysis. Reprod Biomed Online. 2019 Jun;38(6):951-960. doi: 10.1016/j.rbmo.2018.12.029. Epub 2018 Dec 22. PMID: 30979611.
Saravelos SH, Cocksedge KA, Li TC. Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum Reprod Update. 2008 Sep-Oct;14(5):415-29. doi: 10.1093/humupd/dmn018. Epub 2008 Jun 6. PMID: 18539641.
Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RH, DE Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006 Feb;4(2):295-306. doi: 10.1111/j.1538-7836.2006.01753.x. PMID: 16420554.
Rey E, Kahn SR, David M, Shrier I. Thrombophilic disorders and fetal loss: a meta-analysis. Lancet. 2003 Mar 15;361(9361):901-8. doi: 10.1016/S0140-6736(03)12771-7. PMID: 12648968.
Thangaratinam S, Tan A, Knox E, Kilby MD, Franklyn J, Coomarasamy A. Association between thyroid autoantibodies and miscarriage and preterm birth: meta-analysis of evidence. BMJ. 2011 May 9;342:d2616. doi: 10.1136/bmj.d2616. PMID: 21558126; PMCID: PMC3089879.
Moffett A, Colucci F. Uterine NK cells: active regulators at the maternal-fetal interface. J Clin Invest. 2014 May;124(5):1872-9. doi: 10.1172/JCI68107. Epub 2014 May 1. PMID: 24789879; PMCID: PMC4001528.
Bahri Khomami M, Shorakae S, Hashemi S, Harrison CL, Piltonen TT, Romualdi D, Tay CT, Teede HJ, Vanky E, Mousa A. Systematic review and meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Nat Commun. 2024 Jul 4;15(1):5591. doi: 10.1038/s41467-024-49749-1. PMID: 38965226; PMCID: PMC11224312.
Nelen WL, Blom HJ, Steegers EA, den Heijer M, Thomas CM, Eskes TK. Homocysteine and folate levels as risk factors for recurrent early pregnancy loss. Obstet Gynecol. 2000 Apr;95(4):519-24. doi: 10.1016/s0029-7844(99)00610-9. PMID: 10725483.
Gonçalves DR, Braga A, Braga J, Marinho A. Recurrent pregnancy loss and vitamin D: A review of the literature. Am J Reprod Immunol. 2018 Nov;80(5):e13022. doi: 10.1111/aji.13022. Epub 2018 Jul 27. PMID: 30051540.
Ozgör B, Selimoğlu MA. Coeliac disease and reproductive disorders. Scand J Gastroenterol. 2010 Apr;45(4):395-402. doi: 10.3109/00365520903508902. PMID: 20017709.
Xu Y, Nisenblat V, Lu C, Li R, Qiao J, Zhen X, Wang S. Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial. Reprod Biol Endocrinol. 2018 Mar 27;16(1):29. doi: 10.1186/s12958-018-0343-0. PMID: 29587861; PMCID: PMC5870379.
Badawy A, State O, Abdelgawad S. N-Acetyl cysteine and clomiphene citrate for induction of ovulation in polycystic ovary syndrome: a cross-over trial. Acta Obstet Gynecol Scand. 2007;86(2):218-22. doi: 10.1080/00016340601090337. Erratum in: Acta Obstet Gynecol Scand. 2021 Jun 23. doi: 10.1111/aogs.14195. PMID: 17364286.
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van Die MD, Burger HG, Teede HJ, Bone KM. Vitex agnus-castus extracts for female reproductive disorders: a systematic review of clinical trials. Planta Med. 2013 May;79(7):562-75. doi: 10.1055/s-0032-1327831. Epub 2012 Nov 7. PMID: 23136064.

Recurrent Miscarriage: Causes, Investigation & Naturopathic Treatment in Toronto

What Is Recurrent Miscarriage?