A Fertility Acupuncturist’s Perspective
Miscarriage refers to the loss of a pregnancy before 24 weeks, often described as during the first 23 weeks. Beyond the physical event, it can carry a significant emotional and psychological impact.
During this time, many women find themselves navigating a complex landscape of information, decisions, and support. Understanding what is available through the NHS, what requires referral, and what may involve private care can feel challenging at an already difficult time.
The desire for answers is entirely natural. Yet even in cases of recurrent miscarriage, investigations do not always reveal a clear explanation. Many women describe repeated loss being attributed to “bad luck”, with the advice simply being to try again. Recurrent miscarriage can have a significant emotional impact, affecting confidence, wellbeing, and the sense of trust in one’s own body.
Having experienced recurrent miscarriage myself, I understand how disorientating this period can feel. In clinical practice, I now support women navigating this same path and recognise how valuable it can be to control the controllable and explore supportive options.
Miscarriage: Causes and investigations
From a medical perspective, chromosomal abnormalities are recognised as the most common cause of an individual miscarriage. These changes are usually chance events and are not typically associated with something that could have been predicted or prevented.
The products of conception is not always tested for chromosomal abnormalities, and access to testing can vary depending on individual circumstances and local services. As a result, many women do not receive a definitive explanation for their loss.
Recurrent miscarriage is commonly defined as three or more first-trimester losses and is estimated to affect around one percent of couples. In the UK, investigations are most often offered after three miscarriages, although some services may consider earlier assessment depending on clinical history.
According to NHS guidance:
• Further investigations are usually offered after recurrent losses
• No clear cause is identified in around half of cases
• Early ultrasound scans are often offered in subsequent pregnancies
Investigations after recurrent miscarriage
Investigations are not typically offered after a single miscarriage and are often still not offered after a second loss. Being advised to ‘try again’ following two miscarriages, with no change in approach, can feel difficult to accept.
Following three pregnancy losses, investigations are usually offered within NHS care.
These commonly include:
• Coagulation and clotting panels, including antiphospholipid antibodies
• Thyroid function testing
• Screening for conditions such as coeliac disease
In some cases, you may be offered further pelvic investigations such as ultrasound, HyCoSy, hysteroscopy, laparoscopy or biopsy.
Depending on clinical history, additional investigations, including genetic testing, may also be considered.
Private testing
In some situations, investigations accessed outside of NHS care may also be valuable in cases of recurrent miscarriage. These can include more detailed hormone panels, sperm DNA fragmentation testing, microbiome testing, and selected immune investigations, such as natural killer cell assessment or TH1/TH2 profiling.
For couples undergoing IVF, discussions may sometimes include the potential role of preimplantation genetic testing (PGT-A) and other specialist endometrial investigations.
The often overlooked 50%
Recurrent miscarriage affects both partners, yet male investigations are not always explored early on.
Sperm quality plays an important role in embryo development. Even when a standard semen analysis appears normal, elevated sperm DNA fragmentation may still be present. Increased DNA fragmentation has been associated with recurrent pregnancy loss.
In selected cases, further discussions with a fertility clinic or specialist may include:
• Sperm DNA fragmentation testing
• Assessment for infection or inflammation
• Evaluation of oxidative stress where appropriate
The need for reassurance and agency
Following pregnancy loss, many women understandably wish to feel they are doing something proactive. This often leads them to explore supportive approaches such as acupuncture.
Even after a single miscarriage, women may choose to:
• Review hormone patterns
• Track ovulation
• Assess luteal phase length
• Explore nutritional status
For many, gathering information and feeling supported helps restore a sense of control.
Pregnancy after loss
Pregnancy following recurrent miscarriage can feel emotionally complex. Hope may sit alongside worry, particularly during the early weeks.
The time between scans can feel long and uncertain. Many women move quietly through this period, waiting before sharing their news. Many women navigate this period largely on their own, often waiting until 12 weeks, or sometimes beyond, before feeling ready to share their news.
During this stage, supportive care can feel especially important. Having space to talk openly about fears, hopes, and uncertainty may help make the experience feel more manageable.
A Chinese medicine perspective
Medical investigations and test results are an important part of recurrent miscarriage care. Chinese medicine complements this by applying a traditional diagnostic framework that evaluates menstrual health, cycle characteristics, and broader symptom patterns.
Careful attention is given to features such as cycle length, ovulation timing, luteal phase characteristics, menstrual blood quality, and systemic symptoms as well as tongue and pulse diagnosis. These observations help guide diagnosis and inform treatment strategy.
Within this framework, diagnosis focuses on identifying patterns of imbalance, including aspects of blood quality and circulation, alongside functional systems described in Chinese medicine as Kidney, Spleen, and Liver patterns.
Chinese medicine also recognises the close relationship between emotional wellbeing and physical health. Emotions such as grief, sadness, anxiety, fear, or shock are understood as significant influences on physiological balance and are always considered within treatment planning.
Working in an integrated way
Fertility acupuncturists often spend significant time with patients, during which patterns may be identified. Occasionally, this can help highlight issues that warrant further medical investigation.
Symptoms such as persistent pelvic pain, unusual bleeding patterns, digestive concerns, or signs of hormonal imbalance may prompt referral.
Where acupuncture can offer support
Following miscarriage, many women describe feeling physically depleted and emotionally overwhelmed. Sleep disruption, anxiety, and heightened stress responses are common.
Acupuncture is used to support:
• Nervous system regulation
• Sleep quality
• Reduction of physiological stress responses
• Promotion of parasympathetic activity
After miscarriage, Chinese medicine places strong emphasis on recovery before attempting conception again.
Many women find this kind of support easier to manage during a very difficult period.
Finding support
Recurrent miscarriage is complex, and every woman’s experience is different. While investigations do not always provide clear answers, appropriate support and care can make a meaningful difference.
Resources such as Tommy’s and the Miscarriage Association offer valuable information and support.
For women who wish to explore acupuncture as part of their wider support network, this can be discussed with a qualified practitioner experienced in fertility care.
If you would like to explore whether acupuncture may be appropriate for you, this is a conversation you are welcome to have with Anna or Claire.
About
Claire Norton, fertility acupuncturist based in Leicester, is a British Acupuncture Council member with over 14 years of experience supporting women through conception, IVF, and recurrent miscarriage.
