Can male health contribute to recurrent miscarriage? Here’s what to know

What is a miscarriage?

A miscarriage is an unexplained pregnancy loss that occurs before 20 weeks of gestation. We’re not sure exactly how common miscarriages are but it seems that most occur before 14 weeks of gestation and affect 10-25% of pregnancies). Almost one in four women will experience a miscarriage in their lifetimes, with risk increasing with age (risk of miscarriage is 50% for women aged over 40 years).

You can learn more about miscarriage and men here.

What is recurrent miscarriage?

Recurrent miscarriage refers to a pregnancy loss before 20 weeks of gestation that occurs after a previous miscarriage (even if there has been a successful pregnancy in between). Recurrent miscarriages affect 1-4% of Australian couples.

What causes miscarriage?

Most miscarriages appear to be caused by genetic abnormalities in the developing baby and placenta. Abnormal numbers of chromosomes (aneuploidy), caused by problems with chromosome separation during cell division when sperm and eggs are formed, are present in about 40% of recurrent miscarriages. There are chromosomal abnormalities in males that cause pregnancy loss but aneuploidy originates much more often from the egg than the sperm.

Increasing age of mothers and fathers is associated with increased risk of miscarriage. There’s a definite increased risk of miscarriage for fathers aged over 40 years (compared to those aged under 29) but the effect of age probably starts earlier. Most other established risk factors relate to mothers rather than fathers (e.g. body mass index, smoking, alcohol consumption, preexisting health conditions) because most of the research on miscarriage has focussed on mothers. So, it doesn’t hurt (and probably will help) if men prioritise their health while trying to conceive , since there is evidence that it’s beneficial to other reproductive problems such as infertility.

Learn more about preconception health and how to improve it here.

Do male factors contribute to miscarriage?

Metabolic syndrome (a collection of conditions including obesity, hypertension, dyslipidaemia, and diabetes) is the only health condition in males that is associated with miscarriage. However, the lack of established paternal risk factors for miscarriage is more due to an absence of evidence rather than evidence of an absence of paternal effects.

Metabolic syndrome is largely manageable through lifestyle change and medical care. A balanced diet (more vegetables, legumes and whole grains, less processed food and alcohol) alongside regular exercise, including at least 150 minutes of moderate activity per week, can meaningfully improve metabolic markers, even with modest weight loss. Because metabolic syndrome involves several related risk factors rather than one single condition, a GP can help assess which components are present and put together a management plan, which may include medication for blood pressure, cholesterol or blood sugar alongside lifestyle changes.

Recurrent miscarriage causes: Do male factors contribute to recurrent pregnancy loss?

Around half of recurrent miscarriages are unexplained. Recent research focused on male contributions to recurrent miscarriage is beginning to help our understanding.

There is an association between recurrent miscarriage and sperm DNA fragmentation but there is no evidence demonstrating that sperm DNA fragmentation directly causes miscarriage. Sperm DNA fragmentation refers to damage to the DNA within sperm, which can lower the chance of sperm making a healthy embryo or baby. Sperm DNA fragmentation may accompany other abnormalities in sperm, such as changes in protein levels and epigenetic changes that affect pregnancy.

Sperm DNA fragmentation (SDF) testing is not regularly recommended, but you can discuss this with your fertility specialist.

You can find more about the clinical guidelines for the management of male infertility here.

What can men do about recurrent miscarriage?

If you and your partner have experienced recurrent miscarriage, it’s natural to want to understand why and what — if anything — can be done.

A GP can guide you through recurrent miscarriage investigations for both partners at the same time. Re-evaluation of the male partner should be considered where a couple has experienced recurrent pregnancy loss, so don’t hesitate to raise this with your doctor even if previous tests came back normal.

There’s no “right” way to feel after a miscarriage, and no fixed timeline. Miscarriage is often framed as something that happens to the carrying partner, but the loss belongs to both of you. Men feel pressure to put their own grief aside and focus on supporting their partner — for some this can be helpful and for others it might impact how you address your grief.

You might notice anger, irritability or a pull toward withdrawal rather than outward sadness — and that’s a normal, if under-recognised, response. Some men find healthy coping through exercise, creative outlets or staying connected to routine, but it’s worth being mindful of using overwork, alcohol or constant distraction to avoid difficult feelings altogether, as these tend to become unhelpful over time

It can help to be open with your partner about how you’re feeling and you can also chat to friends, family or professional support like a counsellor.

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