3 Essential Tests You Need Before Trying Again After Miscarriage

When “Just Try Again” Isn’t Enough

If you’ve been through the heartbreak of miscarriage, chances are your doctor offered you a familiar line: “It’s common, just try again.”

But for many women, especially those over 35, the advice to simply wait and hope can feel hollow—and risky. Miscarriage is more than a painful event; it can be a sign of underlying issues. Before trying again, miscarriage testing is a vital step toward protecting your next pregnancy.

The truth? Root causes are often overlooked until after multiple losses. But the right fertility bloodwork can help you uncover imbalances early, so you don’t have to go through the same devastation again.

Why Miscarriage Testing Matters

Doctors are trained to treat acute problems, but in the fertility world, that often means many subtle yet critical issues go unchecked. Bloodwork and specialized clotting miscarriage tests can reveal conditions that affect embryo implantation, blood flow to the placenta, or hormonal support of early pregnancy.

Instead of waiting for another loss to prompt more thorough evaluation, you can proactively test now.

The 3 Essential Tests After Miscarriage

1. Comprehensive Hormone & Thyroid Panel

One of the most common—but under-tested—root causes of miscarriage is hormonal imbalance. A single “normal” TSH (thyroid stimulating hormone) result doesn’t tell the whole story.

Ask for:

TSH, Free T3, Free T4, Reverse T3
Thyroid antibodies (TPO, TgAb)
Progesterone tracking across the luteal phase (not just one “day 21” test)
Estradiol and LH for ovarian function

Why it matters:

Low progesterone can make it difficult to sustain pregnancy. (and we know progesterone plummets after 35)
Even “subclinical” thyroid issues (not flagged on standard labs) can raise miscarriage risk. (you need personalized thyroid care)

2. Fertility Bloodwork for Immune & Nutrient Support

Pregnancy relies on a delicate balance of immune tolerance and nutrient sufficiency. When those factors are off, the body may struggle to sustain early development.

Ask for:

Vitamin D, Ferritin (iron stores), B12, Folate (methylated)
Homocysteine (linked to clotting and miscarriage risk)
Inflammatory markers (hs-CRP)
ANA and autoimmune antibody screens

Why it matters:

Low vitamin D alone can double miscarriage risk.
Autoimmune conditions can cause the body to misinterpret pregnancy as a threat.

3. Clotting Miscarriage Tests

Blood flow to the placenta is crucial in early pregnancy. Clotting disorders—often undiagnosed—can cause repeated pregnancy loss. Unfortunately, these tests are rarely run until multiple miscarriages occur (which is heartbreaking to think about let alone experience)

Ask for:

Factor V Leiden mutation
Prothrombin gene mutation
MTHFR gene variants
Antiphospholipid antibodies (lupus anticoagulant, anticardiolipin, β2 glycoprotein I)

Why it matters:

Clotting factors can impair implantation or cut off early placental support.
Identifying these issues can lead to simple, effective interventions (like low-dose aspirin or heparin) that support healthy pregnancy.

Going Deeper: When to Consider Functional Testing

In addition to the “big three,” many women benefit from additional testing that explores insulin sensitivity, toxin exposure, or hidden infections. While not always offered in conventional clinics, these can reveal critical pieces of the fertility puzzle.

Examples include:

Vaginal microbiome tests like post coital tests or tests for urea plasma
Mold and heavy metal testing (environmental triggers)
Cortisol and adrenal function (stress impact on fertility)

Taking Control of Your Next Steps

Here’s the empowering part: you don’t need to wait for multiple losses to deserve answers. You can advocate for these tests now.

Bring a written list (like this one linked here) of tests to your doctor or specialist.
Seek a second opinion if your concerns are dismissed.
Work with a fertility coach who can help you understand and track your results and implement root-cause solutions.

The Bottom Line

Miscarriage testing isn’t about chasing numbers—it’s about protecting your future. With the right fertility bloodwork and clotting miscarriage tests, you can uncover preventable causes of loss and take action before trying again.

Don’t settle for “just try again.” Your story deserves more than chance—it deserves clarity, support, and hope.