There are few experiences in the fertility journey as isolating and heartbreaking as recurrent pregnancy loss.
Each loss carries its own grief. And when it happens more than once, it brings with it a particular kind of fear — not just the fear of loss, but the fear of not knowing why, and the fear of trying again.
If you have experienced two or more miscarriages, this article is written for you.
I want to address two things that come up again and again in my clinic with patients navigating recurrent loss: the feeling that nothing can be done, and the feeling of being alone in the experience.
Neither is true.
How Common Is Recurrent Miscarriage?
Miscarriage is far more common than most people realize. Approximately 10–20% of known pregnancies end in miscarriage — and the true number, accounting for very early losses, is likely higher. Recurrent miscarriage, defined as two or more consecutive pregnancy losses, affects approximately 1–2% of couples trying to conceive.
Despite how common it is, recurrent pregnancy loss remains one of the most under-investigated and under-treated areas of reproductive medicine. Many couples are told to “keep trying” after one or even two losses without being offered a thorough investigation. Others receive investigations that come back normal — leaving them with losses but no answers.
Both situations are profoundly difficult. And both are situations where TCM has something meaningful to contribute.
Causes of Recurrent Miscarriage — What Western Medicine Looks For
When a thorough investigation is undertaken, the most commonly identified causes of recurrent pregnancy loss include:
Chromosomal Abnormalities
The most common cause of any individual miscarriage. Random chromosomal errors during egg or sperm development lead to embryos that are not viable. This becomes more common with age, particularly after 35. In most cases these are random events rather than an inherited chromosomal problem — though parental karyotyping can rule out the latter.
Uterine Abnormalities
Structural issues such as a uterine septum, fibroids, or polyps can interfere with implantation and early placental development. These are typically identified through imaging.
Antiphospholipid Syndrome (APS)
An autoimmune condition in which the immune system produces antibodies that impair blood clotting, leading to clotting in placental vessels and pregnancy loss. This is one of the most treatable causes of recurrent miscarriage when identified.
Hormonal Factors
Thyroid dysfunction, elevated prolactin, and insufficient progesterone in the luteal phase are all associated with increased miscarriage risk. Thyroid antibodies in particular are worth testing even when TSH is technically normal.
Unexplained
Despite thorough investigation, no cause is identified in approximately 50% of recurrent miscarriage cases. This is not reassuring news to receive — but it does mean that a different approach is needed.
If you have not yet had a thorough recurrent pregnancy loss workup, advocating for one is an important first step. Drew can help you understand which investigations are most relevant and work alongside whatever your reproductive specialist recommends.
How TCM Understands Recurrent Pregnancy Loss
Traditional Chinese Medicine has a long clinical history of treating recurrent miscarriage — referred to in classical texts as “Slippery Fetus.” The TCM understanding is that a healthy pregnancy requires both the quality of the embryo and the strength of the mother’s body to hold and nourish it. When recurrent loss occurs, TCM looks for the underlying deficiency or disruption that is preventing the body from sustaining a pregnancy.
Kidney Deficiency
The Kidney system is the foundation of reproductive energy and governs the body’s ability to nourish and hold a pregnancy. Kidney Qi and Yang deficiency in particular are associated with an inability to “grasp” and retain the pregnancy in its early stages. Signs may include lower back weakness or aching, fatigue, cold extremities, frequent urination, and a history of miscarriage at similar gestational ages. This is the most commonly seen pattern in recurrent pregnancy loss.
Blood Deficiency and Liver Blood Deficiency
The Blood nourishes the uterine lining and the developing embryo. When Blood is deficient, the foundation for implantation and early placental development is weakened. Signs include light or scanty periods, pale complexion, poor sleep, anxiety, and fatigue. The Liver stores Blood and is particularly relevant in women who are highly stressed or emotionally depleted by the experience of recurrent loss.
Qi Deficiency
When the overall energy of the body is depleted, its capacity to hold a pregnancy is weakened. Qi Deficiency is often seen alongside Blood or Kidney deficiency, and may present as fatigue, shortness of breath, a tendency to feel unwell easily, and a sense of general depletion. Recurrent loss itself is exhausting — both physically and emotionally — and can deepen this pattern.
Blood Stasis
Impaired circulation in the uterus and pelvis can disrupt implantation and placental development. This pattern is often associated with painful or clotty periods, a history of pelvic surgery or infection, or endometriosis. Blood stasis can also develop as a secondary pattern following repeated pregnancy losses.
Heat Disturbing the Fetus
A pattern of excess heat — often associated with chronic inflammation, autoimmune activity, or significant emotional heat — can destabilise early pregnancy. This pattern may be relevant in women with antiphospholipid syndrome or other inflammatory conditions.
What the Research Shows
The research on acupuncture and TCM for recurrent miscarriage is smaller than for some other fertility conditions, but what exists is encouraging.
A 2021 systematic review found that TCM interventions — including acupuncture and herbal medicine — significantly reduced miscarriage rates in women with recurrent pregnancy loss compared to control groups. Research on acupuncture specifically has shown improvements in uterine blood flow, endometrial receptivity, and immune regulation — all of which are relevant to the mechanisms underlying recurrent loss.
Treatment Approach
Acupuncture
Treatment between pregnancies focuses on building the foundational strength of the body — nourishing Kidney energy, building Blood, improving uterine circulation, and addressing any pattern of stasis or heat. This preparatory phase, ideally covering at least two to three menstrual cycles before attempting pregnancy again, is the most important investment in a healthier next pregnancy.
During a pregnancy following recurrent loss, acupuncture can be continued safely and is often recommended through the first trimester. Treatment during pregnancy focuses on supporting Kidney Qi to hold the pregnancy, calming the nervous system, and addressing any symptoms of anxiety or physical discomfort.
Chinese Herbal Medicine
Herbal medicine has a long history of use in recurrent pregnancy loss within TCM. Classical formulas specifically used for this presentation include modifications of Shou Tai Wan (Fetal Longevity Pill) — a formula specifically designed in TCM for habitual miscarriage. Herbal medicine is typically used between pregnancies; during pregnancy, herbs are selected very carefully and only when clearly indicated.
Supplements
• Folate (methylfolate form) — essential for neural tube development; the methylated form is particularly important for women with MTHFR gene variants, which are more common in recurrent miscarriage populations
• Vitamin D — low levels are associated with increased miscarriage risk; deficiency is extremely common in Canada and should be tested and corrected
• CoQ10 — supports egg quality
• Vitamin B6 and B12 — involved in progesterone metabolism and homocysteine regulation; elevated homocysteine is associated with pregnancy loss
• Omega-3 fatty acids — anti-inflammatory support; may be particularly relevant in immune-mediated miscarriage
• NAC (N-Acetyl Cysteine) — antioxidant with specific research in recurrent miscarriage showing reduced loss rates in women with unexplained recurrent pregnancy loss
Lifestyle
• Stress support — elevated cortisol suppresses progesterone and impairs immune regulation. Genuine stress support is a legitimate clinical priority
• Sleep — progesterone production is significantly regulated by sleep quality. Prioritising sleep is particularly important in the luteal phase
• Anti-inflammatory diet — reduce processed and inflammatory foods; emphasise colourful vegetables, quality proteins, and healthy fats
• Alcohol avoidance — strongly associated with increased miscarriage risk; complete avoidance is recommended in the periconception period
• Thyroid optimization — even subclinical hypothyroidism and thyroid antibodies are associated with increased miscarriage risk; ensure your thyroid has been properly assessed
Preparing for the Next Pregnancy
The period between losses is one of the most difficult to navigate — there is grief to process, fear to manage, and uncertainty about when and whether to try again.
From a TCM perspective, this period is also an opportunity. Building the body’s foundational strength before the next pregnancy — through acupuncture, herbal medicine, targeted supplementation, and lifestyle support — creates meaningfully better conditions for a successful outcome.
A minimum of two to three months of treatment before trying again is typically recommended. For women who have experienced three or more losses, a longer preparatory phase may be appropriate.
This is not about waiting indefinitely. It is about using the time productively — so that when you do try again, your body is in the best possible position to support a healthy pregnancy.
Working With Drew
Drew works with women and couples navigating recurrent pregnancy loss with particular care and attention to the emotional dimensions of this experience. He understands that clinical detachment is not what is needed here — and that the journey through recurrent loss requires support that addresses the whole person, not just the pattern.
His approach begins with a thorough intake that takes the full history of your losses seriously — timing, symptoms, investigations, results — alongside the standard TCM assessment of pulse and tongue. A treatment plan is developed for the preparatory phase between pregnancies, with a clear protocol for transitioning into pregnancy support when the time comes.
You do not have to navigate this alone.
Key Research References
• TCM interventions for recurrent miscarriage — systematic review 2021:
• NAC and recurrent miscarriage — randomized controlled trial:
• Acupuncture and uterine receptivity in recurrent implantation failure:
• Vitamin D deficiency and miscarriage risk — meta-analysis: