Miscarriages Might Be Not What You Think They Are

Something I want women who have gone through miscarriage to read today, because most of them have never been told this.

When a woman miscarries, especially more than once, the conversation almost always goes the same way. Was she too stressed? Did she push herself too hard? Did she eat the wrong thing, sleep wrong, work too much? The assumption is immediate and it almost always lands on her. She carries not just the loss but the quiet accusation that her body failed, or worse, that she did something to cause it.

That assumption is incomplete and in many cases simply wrong. The American Society for Reproductive Medicine just released its first major update on recurrent pregnancy loss since 2012, and one of the most important things it addresses is the male factor. Specifically, something called sperm DNA fragmentation, which is damage to the genetic material carried by sperm. Two recent meta-analyses found that male partners in couples experiencing recurrent miscarriage had significantly higher sperm DNA fragmentation levels than men in couples without this history. Higher fragmentation has also been directly associated with increased miscarriage risk.

What causes this damage in sperm? Smoking, increasing paternal age, fever, environmental exposures, and a condition called varicocele are all listed as contributing factors. The updated guidance now says that sperm DNA testing should be considered when repeated losses remain unexplained. Not as a way to shift blame from one partner to the other, but because pregnancy is a shared biological process and the evaluation needs to reflect that.

For years, the medical workup for recurrent miscarriage focused almost entirely on the woman. Her hormones, her uterus, her chromosomes, her lifestyle. The man was largely left out of the conversation. This update begins to change that.

If you have experienced recurrent pregnancy loss and no clear cause was ever found, it may be worth asking your doctor about evaluating both partners. That conversation is now supported by the latest medical guidance, and you deserve a complete picture, not just half of one.