Recurrent miscarriage - Wokingham, Berkshire

On this page

1. Overview
2. Types of miscarriage
3. Signs and symptoms
4. Causes
5. Miscarriage in Chinese medicine
6. Acupuncture for miscarriage
7. Chinese herbal medicine for miscarriage
8. Emotional support
9. Treatment at my clinic
10. Frequently asked questions
11. References

1. Overview

Miscarriage is the spontaneous loss of a pregnancy before 24 weeks of gestation. It is far more common than many people realise: approximately 10–20% of confirmed pregnancies end in miscarriage, and the true rate is higher still when very early losses before a missed period are included. Recurrent miscarriage — defined in the UK as the loss of three or more pregnancies — affects around 1–2% of couples trying to conceive. The NHS does not routinely investigate the causes of miscarriage until a woman has experienced three losses, which leaves many women without answers or support during what is often a devastating time.

Early pregnancy is an anxious period for most women, and the emotional weight of this anxiety increases significantly for those who have previously experienced pregnancy loss. Getting to the 12-week milestone can feel like an enormous hurdle — one that grows higher with advancing maternal age or a history of previous losses.

Acupuncture and Chinese herbal medicine have a long history of use in supporting pregnancy and reducing the risk of miscarriage. Research supports their role in improving uterine blood flow, supporting implantation, regulating immune factors that can cause pregnancy rejection, and addressing the emotional distress that accompanies pregnancy loss. I have helped many couples in Wokingham through the experience of recurrent miscarriage and go on to have successful pregnancies.

2. Types of miscarriage

In the UK, any pregnancy loss before 24 weeks of gestation is classified as a miscarriage; loss after 24 weeks is classified as a stillbirth. The main clinical presentations include:

1. Threatened miscarriage — vaginal bleeding in early pregnancy where the cervix remains closed and the pregnancy is still viable on ultrasound. A threatened miscarriage does not always lead to a complete loss, but it increases the risk of subsequent miscarriage, preterm labour and low birthweight. It is a common early pregnancy complication and is currently treated by most NHS services with a “wait and see” approach, as no standard pharmacological intervention is recommended. This is precisely where acupuncture and Chinese herbs can offer meaningful therapeutic support.
2. Complete miscarriage — all pregnancy tissue has been passed naturally from the uterus.
3. Incomplete miscarriage — some pregnancy tissue remains in the uterus after the loss has begun.
4. Missed miscarriage (silent miscarriage) — the embryo or foetus has stopped developing but has not yet been passed. The woman may still have pregnancy symptoms and is often unaware until an ultrasound scan.
5. Recurrent miscarriage — defined as three or more consecutive pregnancy losses. Recurrent miscarriage appears to be increasing in incidence, with causes that are often multifactorial and sometimes remain unexplained even after thorough investigation. Traditional Chinese medicine offers a comprehensive diagnostic and treatment framework that can identify and address underlying imbalances even where conventional investigation has not found a cause.
6. Biochemical pregnancy — a very early pregnancy loss that occurs shortly after implantation, typically only detectable by a sensitive pregnancy test. These early losses are extremely common and are often not counted in the NHS recurrent miscarriage definition, yet they are deeply distressing for women who are trying to conceive.

3. Signs and symptoms

The signs that a miscarriage may be occurring include:

1. Vaginal bleeding, ranging from light spotting to heavy bleeding with clots
2. Cramping or pain in the lower abdomen or back, similar to period pain
3. A sudden reduction or disappearance of pregnancy symptoms such as nausea, breast tenderness and fatigue
4. Passage of tissue or fluid from the vagina

It is important to note that some of these symptoms — particularly light spotting — are also common in normal early pregnancies. They do not always indicate a miscarriage, and any bleeding in pregnancy should be assessed by a healthcare professional. It can sometimes be difficult to distinguish between the early signs of pregnancy, implantation bleeding and a threatened miscarriage without an ultrasound scan.

4. Causes

The majority of first-trimester miscarriages are caused by chromosomal abnormalities in the embryo. Approximately 50–70% of first-trimester losses involve chromosomal abnormalities that make it impossible for the pregnancy to develop normally. The rate of chromosomal abnormality as a cause of miscarriage decreases in the second trimester to around 20% overall.

The three main categories of cause are:

1. Egg quality — poor egg quality is the most common cause of chromosomally abnormal embryos. Egg quality declines with age, particularly after 35, and the risk of miscarriage due to chromosomal abnormality rises significantly with maternal age. In women aged 40, the risk of miscarriage is approximately 10 percentage points higher than in women aged 35. Egg quality can be supported with acupuncture and herbal medicine.
2. Sperm quality and DNA fragmentation — sperm quality, and in particular sperm DNA fragmentation, is an increasingly recognised contributor to miscarriage risk. High levels of sperm DNA damage reduce the embryo’s ability to develop normally and increase the likelihood of early pregnancy loss. Male factor causes of recurrent miscarriage are often overlooked in conventional investigation. Acupuncture and Chinese herbs have good evidence for improving sperm DNA integrity.
3. Uterine receptivity and implantation — even a chromosomally normal embryo will fail to implant and sustain if the uterine environment is not optimal. Inadequate blood flow to the endometrium, a thin or poorly developed uterine lining, uterine abnormalities (such as fibroids or polyps), and immunological factors that cause the immune system to reject the embryo can all contribute to miscarriage.

Additional contributing factors for recurrent miscarriage include antiphospholipid syndrome (APS) and other thrombophilic conditions, hormonal imbalances (including PCOS, thyroid dysfunction and luteal phase deficiency), uterine structural abnormalities, chronic stress, and advanced maternal age.

In cases where miscarriage occurs during or after an IVF cycle, the risk of chromosomal abnormality is often greater because the ovaries have been stimulated to produce multiple eggs simultaneously, which can reduce egg quality. In such cases it is particularly advisable to prepare the body thoroughly before undertaking another cycle.

5. Miscarriage in Chinese medicine

In traditional Chinese medicine (TCM), pregnancy is sustained by the combined Kidney Jing (essence) of both parents, which provides the constitutional foundation for the embryo, and by the mother’s Kidney Yang, which holds and warms the pregnancy, and the Chong and Ren extraordinary vessels, which govern the uterus and menstrual cycle.

The main TCM patterns contributing to miscarriage include:

1. Kidney Jing (essence) deficiency — the most fundamental pattern underlying recurrent miscarriage. When the Jing contributed by either parent’s egg or sperm is insufficient, the embryo lacks the constitutional resources to develop normally. This corresponds closely to the biomedical concept of poor egg or sperm quality and chromosomal abnormality. In TCM terms, chromosomal abnormalities are understood as an expression of insufficient Jing in the embryo, which may reflect a deficiency from either or both parents. Treatment focuses on tonifying and consolidating Kidney Jing in both partners before conception.
2. Kidney Yang deficiency failing to hold the pregnancy — a pattern where the warming, anchoring action of Kidney Yang is insufficient to sustain the implanted embryo, leading to repeated early losses, often accompanied by cold extremities, low back aching, fatigue and frequent urination.
3. Qi and Blood deficiency — insufficient Qi and Blood to nourish the growing embryo and maintain the uterine environment. This often follows Blood loss from a previous miscarriage or is seen in women with heavy periods, anaemia or postpartum depletion.
4. Liver Qi stagnation — emotional distress, grief and stress — which are both causes and consequences of recurrent miscarriage — constrain the flow of Liver Qi, disrupting the smooth circulation of Blood to the uterus and the hormonal regulation governed by the Liver’s function of ensuring free flow throughout the body. This pattern is frequently present alongside the deficiency patterns above.
5. Heat in the Blood — a pattern associated with threatened miscarriage presenting with bright red vaginal bleeding, restlessness and a feeling of heat. Treatment cools and calms the Blood to help arrest the bleeding and stabilise the pregnancy.

6. Acupuncture for miscarriage

Acupuncture can support pregnancy and reduce miscarriage risk through several well-documented mechanisms. It increases uterine blood flow, improving the quality of the endometrial lining and supporting implantation. It modulates the immune system, regulating the natural killer (NK) cell activity and inflammatory cytokines that, when dysregulated, can cause the body to reject an embryo. It regulates the hormonal axis, supporting progesterone production and luteal phase function. And it addresses the stress and anxiety that both increase miscarriage risk and make the experience of pregnancy loss more difficult to bear.

The stimulation of acupuncture points associated with the Chong and Ren extraordinary vessels — the vessels that govern uterine function in TCM — can help to consolidate the uterus, arrest threatened bleeding and support the embryo in the critical early weeks of implantation.

Research evidence

A feasibility randomised controlled trial by Betts et al. (2016), published in BMC Pregnancy and Childbirth, examined acupuncture as a therapeutic treatment for threatened miscarriage and found that women who received acupuncture reported reduced concern about their primary symptoms — including vaginal bleeding and cramping — and expressed a preference for acupuncture over the standard medical “wait and see” approach, which gave them a greater sense of agency over their condition. An earlier discussion paper by the same research group (Betts et al., 2012) outlined the theoretical basis and mechanism for acupuncture as a therapeutic intervention for threatened miscarriage. Research by Stener-Victorin et al. (2003) demonstrated that electroacupuncture stimulation significantly increases ovarian and uterine blood flow, an effect of direct relevance to supporting implantation and early pregnancy. Research by Kim et al. (2010) confirmed that acupuncture has significant immune-modulating effects, including the regulation of the cytokine environment relevant to embryo acceptance. A 2023 case report and review by Feng et al. published in Acupuncture (Feng et al., 2023) further documented the clinical use of acupuncture in treating threatened miscarriage, including in a patient with post-transfer intrauterine haematoma who declined pharmaceutical intervention.

7. Chinese herbal medicine for miscarriage

Chinese herbal medicine has been used for thousands of years to support pregnancy, prevent miscarriage and address the underlying constitutional deficiencies that lead to recurrent pregnancy loss. The research evidence now supports these traditional uses.

A 2023 updated systematic review and meta-analysis by Xie et al., published in Frontiers in Pharmacology, evaluated the efficacy and safety of Chinese herbal medicine (CHM) for threatened miscarriage through a comprehensive search of databases up to June 2022. The review found that combined CHM and Western medicine achieved better outcomes for threatened miscarriage than Western medicine alone (Xie et al., 2023). A 2016 Cochrane systematic review by Li et al. evaluated CHM for unexplained recurrent miscarriage and concluded that Chinese herbal medicines may improve pregnancy outcomes for women with a history of recurrent loss (Li et al., 2016). An earlier systematic review by Yang et al. (2013) of 41 RCTs involving 3,660 participants found that CHM used alone or combined with progesterone showed superior effect over progesterone-based treatment alone in improving live birth rates and embryonic developmental status in women with recurrent miscarriage (Yang et al., 2013).

Key classical Chinese herbal formulas used to support pregnancy and prevent miscarriage include Shou Tai Wan (Fetus Longevity Pill), which tonifies Kidney Jing and stabilises the Chong and Ren vessels; Bu Shen Gu Chong Wan, which tonifies Kidney Yang and consolidates the uterus; and An Tai Yin (Calm Foetus Decoction) for acute threatened miscarriage with bleeding. Individual herbs with well-documented tocolytic, uterine-supporting and immune-modulating properties include Tu Si Zi (Cuscuta seed), Sang Ji Sheng (Mulberry mistletoe), Xu Duan (Dipsacus root) and E Jiao (Donkey hide gelatin).

I prescribe pharmaceutical-grade Chinese herbal granules from Sun Ten (Taiwan), independently tested for purity and safety. For patients who cannot attend the clinic in person, I offer online Chinese herbal medicine consultations with herbs dispensed by post.

8. Emotional support

Miscarriage can be devastating, and the grief that follows — whether after a single loss or after many — is real, valid and often underestimated by those around the couple. The experience of recurrent miscarriage in particular takes a profound toll on emotional wellbeing, relationships and the ability to feel hopeful about future pregnancies.

In Chinese medicine, unresolved grief, chronic stress and emotional suppression are understood as direct contributors to the physical imbalances that increase miscarriage risk, particularly Liver Qi stagnation and Kidney deficiency. Addressing the emotional dimension of treatment is therefore not separate from the physical treatment — it is an integral part of it.

Acupuncture can provide significant emotional support during and after pregnancy loss, helping to regulate the nervous system, reduce anxiety and depression, and begin the process of physical recovery after a loss. I recommend that counselling or psychotherapy is sought alongside acupuncture treatment, particularly for women with recurrent miscarriage, as part of a holistic programme of support.

9. Treatment at my clinic

I treat miscarriage, threatened miscarriage and recurrent pregnancy loss at my clinics in Wokingham, Berkshire. I also offer online Chinese herbal medicine consultations for patients who are unable to attend in person.

Treatment for recurrent miscarriage involves a thorough TCM consultation to identify the specific pattern of imbalance in both partners, followed by a programme of acupuncture and Chinese herbal medicine aimed at addressing the root causes before the next conception attempt. I advise patients to allow a minimum of three months of preparatory treatment to strengthen the constitution, improve egg and sperm quality, and optimise the uterine environment before trying again. This is especially important before a further IVF cycle.

Once pregnancy is achieved, treatment continues through the first trimester — the period of highest risk — with weekly acupuncture sessions and continued Chinese herbs to support implantation and stabilise the early pregnancy. Treatment can be maintained through the second trimester as clinically appropriate. For more information, read My Fertility Guide or visit the prices page.

10. Frequently asked questions

Can acupuncture reduce the risk of miscarriage?

Yes. Acupuncture supports pregnancy by improving uterine blood flow, regulating immune factors that can cause embryo rejection, supporting progesterone production and reducing the stress response. Research supports its use for threatened miscarriage, and it has a long clinical history in TCM as a treatment for pregnancy loss. For women with recurrent miscarriage, acupuncture combined with Chinese herbs forms an evidence-based preparatory programme before the next conception attempt.

When should I start acupuncture to reduce the risk of miscarriage?

Ideally, treatment should begin at least three months before trying to conceive again after a miscarriage. This allows sufficient time to address the underlying constitutional deficiencies — particularly Kidney Jing and egg quality — that are the root cause of most recurrent pregnancy losses. If you are already pregnant and experiencing a threatened miscarriage with bleeding or cramping, treatment can begin immediately.

Is Chinese herbal medicine safe during pregnancy?

Chinese herbal formulas used for pregnancy support and threatened miscarriage are specifically selected to be safe in early pregnancy. The herbs used in this context — such as Tu Si Zi, Sang Ji Sheng, Xu Duan and E Jiao — are among the most commonly used pregnancy-supporting herbs in TCM and have been used safely for centuries. I prescribe only pharmaceutical-grade herbs from Sun Ten (Taiwan) and take a full medical history before prescribing to ensure all formulas are appropriate for the individual patient.

How does acupuncture help after a miscarriage?

After a miscarriage, acupuncture supports physical recovery by helping the body clear the uterus fully, regulate the menstrual cycle and restore hormonal balance. It also provides significant emotional support by calming the nervous system and addressing the grief, anxiety and depression that commonly follow pregnancy loss. I recommend a recovery programme before attempting to conceive again.

Can male factor issues cause miscarriage?

Yes. Sperm DNA fragmentation is an increasingly recognised contributor to recurrent miscarriage that is frequently overlooked in conventional investigation. When sperm DNA damage is high, even a fertilised egg may fail to develop normally, resulting in early pregnancy loss. Acupuncture and Chinese herbs have good evidence for reducing sperm DNA fragmentation and improving overall male fertility. It is important that both partners are assessed and treated in cases of recurrent miscarriage.

Can I have acupuncture alongside my NHS recurrent miscarriage investigation?

Yes. Acupuncture and Chinese herbal medicine work comfortably alongside all NHS investigation and treatment for recurrent miscarriage, including progesterone supplementation, anticoagulant therapy and immunological treatments. TCM treatment complements rather than replaces conventional medical care.

11. References

Stener-Victorin E, Waldenström U, Säflund K, Lofman CO. Ovarian blood flow responses to electro-acupuncture stimulation at different frequencies and intensities in anaesthetized rats. Autonomic Neuroscience: Basic and Clinical. 2003;108:50–56. https://doi.org/10.1016/j.autneu.2003.09.004.

Kim J, et al. Acupuncture and immune modulation. Autonomic Neuroscience: Basic and Clinical. 2010;157:38–41. https://doi.org/10.1016/j.autneu.2010.03.010.

Song J, et al. Clinical observation on acupuncture for treatment of infertility of ovulatory disturbance [Chinese]. Zhongguo Zhenjiu. 2008;28(1):21–3. PMID: 18257182.

Betts D, Smith CA, Hannah DG. Acupuncture as a therapeutic treatment option for threatened miscarriage. BMC Complement Altern Med. 2012 Mar 22;12:20. https://doi.org/10.1186/1472-6882-12-20.

Betts D, Dahlen HG, Smith CA. Does acupuncture have a role in the treatment of threatened miscarriage? Findings from a feasibility randomised trial and semi-structured participant interviews. BMC Pregnancy and Childbirth. 2016;16:298. https://doi.org/10.1186/s12884-016-1092-8.

Yang GY, Luo H, Liao X, Liu JP. Chinese herbal medicine for the treatment of recurrent miscarriage: a systematic review of randomized clinical trials. 41 RCTs, 3,660 participants. BMC Complementary and Alternative Medicine. 2013;13:320. https://doi.org/10.1186/1472-6882-13-320.

Li L, Dou L, Leung PC, Chung TK, Wang CC. Chinese herbal medicines for unexplained recurrent miscarriage. Cochrane Database of Systematic Reviews. 2016 Jan 14;2016(1):CD010568. https://doi.org/10.1002/14651858.CD010568.pub2.

Feng J, Li Q, Zhang X, Zhao S, Guo T. Acupuncture Treatment for Threatened Abortion. Acupuncture. 2023 Feb 1;35(1):43–47. https://doi.org/10.1089/acu.2021.0087.

Xie H, Zhang A, Mou X, He T, Li J, Wang CC, Fan X, Li L. Chinese herbal medicine for threatened miscarriage: an updated systematic review and meta-analysis. Frontiers in Pharmacology. 2023 Feb 14;14:1083746. https://doi.org/10.3389/fphar.2023.1083746.