What can you do to reduce the risk of miscarriage?

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.