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Questions to ask

Can we start the recurrent pregnancy loss evaluation before I try again, rather than waiting?
A threshold is when testing is offered, not when you're allowed to ask. Two or more losses meets the ASRM definition (non-consecutive counts, chemical pregnancies count), and one loss at or after 10 weeks is already a recognised reason to ask for APS testing.
If you don't think it's indicated for me, can you help me understand why, and note in my chart that I asked?
This turns a no into a reason. A reason is something you can take to a second opinion.
Can the pregnancy tissue be tested for chromosomes? If it happens again, what's the plan to make sure the tissue actually gets collected and sent?
Agree this in advance. In the moment, nobody is thinking about lab logistics.
Have I been tested for antiphospholipid antibodies — lupus anticoagulant, anticardiolipin, and anti-β2-glycoprotein I? If not, can we start now?
The most commonly skipped treatable cause. A positive needs a confirmatory repeat 12 weeks later, so starting before you conceive is how you get a usable answer in time.
Has my thyroid been checked, and has my uterine cavity been evaluated?
Is there anything in my history that suggests additional testing for me specifically?
If we don't find a cause, what does that mean for my chances next time?
Most people with unexplained recurrent loss go on to have a successful pregnancy.
When I'm ready, is there anything I should do before trying again?
Does my blood type (Rh status) mean I need any treatment after this loss?
Can you refer me to counseling or a support group?
Can I get copies of all my results and notes? (You're entitled to them.)
Who do I contact with questions between appointments, and how quickly should I expect a reply?

Things to bring

Dates and details of each pregnancy and loss, including how far along and any testing done
Any pathology or genetic results from a prior loss
Your cycle and health history, including thyroid or clotting history in your family
Your partner, or someone who can take notes for you

Tests to ask about

The recurrent loss panel, by name. Antiphospholipid antibodies (lupus anticoagulant, anticardiolipin, anti-β2-glycoprotein I), TSH, and a uterine cavity evaluation, plus tissue testing when possible. Asking for the pieces by name gets you further than asking for "the panel." What each one looks for →
Testing the pregnancy tissue. When possible, chromosome testing of the tissue can explain a loss and is now the recommended first step. Time-sensitive: if it isn't collected, that window closes for good.
Antiphospholipid antibodies. Lupus anticoagulant, anticardiolipin, and anti-β2-glycoprotein antibodies. A treatable cause of recurrent loss; treatment usually involves low-dose aspirin and heparin during pregnancy.
Thyroid. TSH, and thyroid antibodies in some cases.
Uterine cavity. Ultrasound, saline sonogram, or hysteroscopy to look for a septum, polyps, fibroids, or scarring.
Parental chromosomes. Karyotyping of both partners is considered in some situations rather than routinely; ask whether it applies to you.
Diabetes and other conditions. Screening when history suggests it.
Support. Counseling and support groups are part of care, not an afterthought.

Nail this down before you leave

Whether you meet the threshold for an evaluation, and if so, which tests are being ordered
What was found, or clearly not found, and what that means for your next pregnancy
What you can ask for early in a next pregnancy (early ultrasound, hormone monitoring) for reassurance
Where to turn for emotional support

Questions that work in any appointment

These four apply to any test, any treatment, any recommendation — and they're the ones that turn a pronouncement into a decision you're part of.

Does this evidence apply to my situation specifically?
What would this test change about our plan?
What are the benefits, the risks, and the alternatives?
What would make you recommend a different approach?

If they say everything looks normal

Which of the standard tests have actually been done, and which haven't?
If everything is normal, what would you look at next, and when?
Is there anything in my history that would make you consider additional testing?
What's the plan from here, and at what point would you change it?

What happens next

If an evaluation finds something, there's usually a specific treatment right behind it. Antiphospholipid syndrome, thyroid conditions, uterine septa and blood sugar are all treatable — and all of them are treated between pregnancies or from the very start of the next one, which is the whole argument for testing before you try again.

If nothing is found, that's not the same as nothing can be done: early monitoring and support in a next pregnancy are reasonable to ask for, and your odds remain good.

There's no timeline for trying again. When you're ready, this same Path, entered through I'm trying again, covers what to ask.

Notes from the appointment

Onward Babe is educational, not medical advice. Everything here is built from published research and professional guidelines so you can have a better conversation with the doctor who actually knows your situation.