Experiencing multiple pregnancy losses can be emotionally devastating, and it is important to seek answers. While chromosomal abnormalities, uterine conditions, hormonal disorders, and immune factors are well recognised causes of recurrent pregnancy loss (RPL), infections are another area that may require investigation in selected patients. Although infections are not the most common cause of recurrent miscarriage, identifying and treating an underlying infection can improve pregnancy outcomes in some cases. If you have experienced two or more pregnancy losses, discussing infection testing with your fertility specialist may help determine whether further evaluation is appropriate.
What Is Recurrent Pregnancy Loss?
Recurrent pregnancy loss or miscarriage is generally defined as two or more consecutive pregnancy losses. While one miscarriage is relatively common, repeated losses deserve a comprehensive medical evaluation to identify any underlying causes and guide appropriate treatment.
Why Are Infections Considered?
Certain infections can affect implantation, early embryo development, placental function, or the uterine environment. Some may cause inflammation or damage to the reproductive tract, while others can interfere with a developing pregnancy. However, it is important to understand that routine infection screening is not recommended for every patient with recurrent pregnancy loss. Testing is usually based on your medical history, symptoms, examination findings, previous pregnancy outcomes, and individual risk factors.
At Harley Street Fertility Centre Kenya, all fertility treatments are preceded by relevant infection screening.
Considerations for Infection Testing
On reviewing your infection screening test results, your doctor will have considered factors such as:
- Symptoms of infection
- Past sexually transmitted infections (STIs)
- Pelvic inflammatory disease (PID)
- Previous uterine surgery
- Travel history
- Previous pregnancy complications
- The number and timing of your pregnancy losses
- Medical conditions affecting your immune system
Which Infections Might Be Relevant in Relation to Miscarriage?
Depending on your history, your doctor may discuss testing for infections such as:
- Chlamydia
- Gonorrhoea
- Mycoplasma and Ureaplasma (in selected cases)
- Bacterial vaginosis
- Syphilis
- HIV
- Hepatitis B and C
- Tuberculosis (particularly in areas where it is common or if risk factors exist)
- During pregnancy or when clinically indicated, additional testing may be considered for infections such as:
- Rubella immunity
- Cytomegalovirus (CMV)
- Toxoplasmosis
- Herpes simplex virus (HSV)
Not every patient requires all of these tests, and some infections are investigated only under specific clinical circumstances.
Should My Partner Be Tested?
Fertility evaluation should always include both partners. Ask whether your partner should undergo: Male infections can sometimes affect sperm quality or contribute to reproductive challenges.
Are There Other Causes of Miscarriage We Should Investigate?
Infections represent only one possible explanation for recurrent pregnancy loss. Your doctor may also recommend investigations for chromosomal abnormalities, uterine abnormalities, hormonal disorders, thyroid disease, diabetes, antiphospholipid syndrome, blood clotting disorders and lifestyle factors. A comprehensive evaluation often provides the best opportunity to identify treatable causes.
If an Infection Is Found, What Happens Next?
Your fertility specialist will help determine if the infection is active or from a previous exposure, whether it requires treatment before trying to conceive again, whether your partner also needs treatment, how long you should we wait before attempting pregnancy again and whether repeat testing will be necessary. Most bacterial infections can be treated successfully with antibiotics, while viral infections may require monitoring or specific management depending on the infection.
Can I Do Anything to Reduce My Risk?
Preventive measures include practising safe sex, seeking prompt treatment for suspected infections, maintaining good personal hygiene, attending regular health check-ups, ensuring vaccinations are up to date before pregnancy and following your healthcare provider’s advice regarding prenatal care.
Remember: Infection Is Only One Piece of the Puzzle
For many couples, recurrent pregnancy loss is caused by factors unrelated to infection, and in some cases, no clear cause is identified despite thorough investigation. This can be frustrating, but many individuals with recurrent pregnancy loss go on to have successful pregnancies with appropriate care and support. Working closely with a fertility specialist ensures that investigations are tailored to your individual circumstances, avoiding unnecessary tests, while identifying conditions that may benefit from treatment.
Key Takeaway
If you’ve experienced recurrent pregnancy loss, don’t hesitate to ask your doctor whether infection testing is appropriate for you. While infections are not the leading cause of recurrent miscarriage, identifying and treating certain infections or uterine inflammation may improve reproductive health in selected patients. A personalised evaluation that considers both partners offers the best chance of finding answers and developing a treatment plan that supports a healthy future pregnancy.
Read about infections and miscarriage in this article by Fertility Centers of New England.
