A miscarriage is a deeply impactful experience. We look for the underlying cause and help you reduce the risk.
A miscarriage is a loss that can have a deep impact — especially when it happens more than once. Many factors may be involved, and the cause isn’t always immediately clear. At the FertilityCare Clinic, we look closely at what may be affecting you. With the right diagnosis and targeted prevention, the risk of another miscarriage can often be reduced.
“After five miscarriages in the early weeks and three miscarriages between the 13th and 24th week, a full-term pregnancy has finally happened.”
A miscarriage rarely has a single clear cause. Often, several factors play a role at the same time — sometimes hormonal, sometimes genetic, or a combination of both. What we do know is that the better we understand what is happening in your body, the more precisely we can tailor treatment and help reduce the risk. Below, you’ll find the most common causes.
A miscarriage often leaves you with questions. Why did it happen? Could anything be different next time? At FertilityCare, we start by looking for answers. We take a close look at your cycle and hormonal profile, identify possible underlying causes, and design a treatment plan tailored to you. Step by step — with personal guidance and medical expertise, both in person and remotely.
Personal stories from women and couples we’ve had the privilege of supporting.
A miscarriage is the loss of a pregnancy within the first 16 weeks, most commonly within the first 12 weeks. After 16 weeks, it is referred to as stillbirth or intrauterine fetal death (IUFD), depending on the exact stage of pregnancy and medical context.
For many women and couples, this is a profound and emotional experience. It often occurs unexpectedly, at a time when there is hope and anticipation. It is entirely understandable that this can lead to feelings of grief, uncertainty, and sometimes guilt.
At the same time, it is important to know that miscarriage is relatively common: approximately 10–15% of pregnancies end in miscarriage. Although emotionally difficult, this does not necessarily mean that there is a permanent problem with fertility.
In many cases, there is a medical explanation, and further investigation can help provide insight and reduce the risk of recurrence.
Preventing miscarriage requires a broad and individualized approach. By looking not only at isolated symptoms but at the overall picture — including hormonal balance, cycle quality, and underlying medical factors — it is often possible to identify points for treatment.
The multifactorial approach of FertilityCare, with a strong focus on improving cycle health, provides a targeted and evidence-based pathway to increasing the chances of a healthy and successful pregnancy.
Ovulation induction treatment can vary depending on the underlying cause and the patient’s medical situation. The most common treatment options include:
Clomiphene citrate (Clomid) — this oral medication is often used as a first-line treatment. It stimulates the hypothalamus to release more FSH and LH, allowing multiple follicles to mature and increasing the chance of ovulation.
Gonadotropins (injections) — if clomiphene citrate is not effective, gonadotropins (injections of FSH and/or LH) may be used. These hormones directly stimulate the ovaries to produce eggs and are often prescribed when stronger stimulation is required, such as in women with reduced ovarian reserve.
Letrozole — this medication is frequently used in women with PCOS, as it stimulates ovulation by reducing estrogen production, which increases FSH release.
Metformin — in women with PCOS, metformin (a medication commonly used for diabetes) may be prescribed to improve insulin sensitivity and support ovulation.
Preconception care
Preventing a miscarriage is not always possible, but in many cases the risk can be reduced through a targeted and individualized approach. The Dutch Society of Obstetrics and Gynecology recommends additional testing in cases of recurrent miscarriage to identify possible underlying causes, such as hormonal, genetic, anatomical, and clotting-related factors.
Within the FertilityCare approach, the focus is on optimizing natural fertility before conception. The menstrual cycle is considered the key starting point. Through systematic cycle monitoring, hormonal patterns are mapped in detail, including follicle development, the timing and quality of ovulation, and hormonal balance in the luteal phase. Abnormalities such as suboptimal ovulation or progesterone deficiency can thus be detected early.
When ovulation is disrupted or absent, ovulation induction may be used. This is a treatment in which ovulation is medically stimulated to achieve a more regular and higher-quality ovulation. This can contribute to improved cycle structure and an increased chance of healthy conception.
In addition to hormonal factors, possible disturbances in the vaginal and endometrial microbiome are also assessed. If there are indications of immunological imbalance — both within the reproductive system and systemically — these are treated where necessary to improve the immune environment.
Based on these insights, an individualized treatment plan is developed. This may include hormonal support, ovulation induction, or optimization of the luteal phase. Depending on the situation, additional investigations may also be performed into thyroid function, metabolic health (such as insulin resistance), clotting, the immune system, and the microbiome.
The goal is to optimize the hormonal and biological conditions for a healthy conception as much as possible.
Therapy during pregnancy
After a positive pregnancy test, care focuses on supporting a stable course of pregnancy, particularly in the early phase when implantation and placental development take place.
Scientific research and clinical observations show that physiological levels of estrogen and progesterone are associated with more favorable pregnancy outcomes. These hormonal reference values form the basis when considering possible supplementation.
When support is indicated, the duration and dosage of hormone supplementation are determined individually and tailored to the clinical course and the patient’s needs.
Care also includes regular monitoring, such as ultrasound examinations and laboratory testing, to track pregnancy development and make timely adjustments when necessary.
In addition, preconceptionally identified and treated factors are taken into account. Treatments initiated before pregnancy — for example for thyroid disorders, clotting disorders, or immune-related conditions — are continued during pregnancy if indicated and adjusted as needed.
The approach is always individualized and based on medical history, previous pregnancy outcomes, and the course of the current pregnancy, with the aim of supporting the most stable and optimal pregnancy progression possible.
A miscarriage is usually caused by a combination of medical factors. Genetic abnormalities in the embryo may play a role. According to the Dutch Society of Obstetrics and Gynecology, this is often due to an error in the distribution of chromosomes during fertilization. This typically occurs by chance and is, in most cases, not hereditary.
In addition, the quality of the menstrual cycle plays an important role in both the occurrence and maintenance of a pregnancy. A disrupted cycle may indicate underlying hormonal problems that increase the risk of miscarriage. For example, poor egg quality may lead to chromosomal abnormalities during conception and problems with implantation. Inadequate ovulation may result in lower progesterone production, a hormone essential for supporting the uterine lining. A shortened luteal phase (the period after ovulation) may also prevent proper implantation or development of a pregnancy.
By closely monitoring the cycle and measuring hormone levels at specific times, these abnormalities can be identified and treated in a targeted way.
In addition to hormonal and cycle-related factors, structural abnormalities of the uterus may also play a role. These include congenital malformations, fibroids (myomas), or adhesions that can interfere with implantation or the growth of a pregnancy.
Furthermore, immunological and clotting disorders, such as antiphospholipid syndrome, are known causes. These can disrupt blood flow to the placenta. In cases of recurrent miscarriage, immunological factors are also considered, where the immune system may play a role.
Other underlying conditions such as thyroid disorders, diabetes, or polycystic ovary syndrome (PCOS) can also increase the risk of miscarriage. For this reason, we do not look at individual symptoms in isolation, but consider the overall picture of immunological factors, hormonal regulation, and cycle quality.
In modern reproductive medicine, increasing attention is also being given to the microbiome of the reproductive system. This refers to the bacterial composition of the vagina and the uterine lining. International research, including the ReceptIVFity cohort studies at Erasmus MC in Rotterdam, suggests a possible link between a healthy environment and improved implantation.
Lifestyle also plays a crucial role. Factors such as smoking, alcohol consumption, overweight, sleep deprivation, and chronic stress can negatively affect both fertility and pregnancy outcomes. A healthy lifestyle — including sufficient rest, balanced nutrition, and stress reduction — helps restore hormonal balance and creates an optimal environment for a developing pregnancy.
More information about the scientific foundation of the FertilityCare method and restorative reproductive medicine can be found on this page in the form of in-depth content and additional materials.
You can also explore the international academic centre International Institute for Restorative Reproductive Medicine (IIRRM), where research, education, and clinical practice are closely connected. Current scientific insights are gathered, evaluated, and applied in practice there.
Natural procreative technology for infertility and recurrent miscarriage 2012
Natural procreative technology – a multifactorial approach to the chronic problem of infertility
Exploration of the Effectiveness of NaProTechnology in Women’s Healthcare 2020
Exploration of the Effectiveness of NaProTechnology in Women’s Healthcare (2020)
On Natural Fertility – Interview with Dr. Susanne van der Velden (2022, Dutch)
Video material is also available, explaining the method and its scientific background in an accessible way.
The course begins with a non-binding introductory session, during which the method is explained step by step using a presentation. This meeting provides time to explain the approach, answer questions, and explore together what the method could mean for you.
This is followed by a course consisting of eight private sessions. These can take place either online or in person. During this phase, you will gradually learn how to observe, record, and interpret your cycle according to the FertilityCare method.
There is a strong focus on personal guidance, ensuring that the method fits well into your daily life.
As the course progresses, the content is further deepened and adapted to your personal situation — for example, in cases of a desire to conceive, cycle-related symptoms, breastfeeding, or the transition into perimenopause.
The course is not a standalone program, but part of a broader medical-diagnostic approach. It serves as both a foundation for understanding your cycle and a starting point for further care, where medical treatment and personal guidance are closely aligned.
To get started, you can contact one of the FertilityCare instructors for an introductory meeting.
Would you like to learn more about our approach and how to make an appointment?
Our approachNB! This translation is automatically generated and may therefore produce grammatically incorrect sentences. As a result, the meaning of the sentence may no longer correspond to the original (Dutch version).