After the long, emotionally and physically demanding journey of in-vitro fertilization (IVF), hearing the words “you’re pregnant” often feels like crossing the finish line. However, for many couples, particularly those navigating fertility challenges, pregnancy is only part of the journey—and miscarriage remains a deeply feared possibility.Experts points out that although IVF brings a lot of couples closer to parenthood, it does not entirely prevent the risk of miscarriage. "About 15% of all pregnancies, whether they occur naturally or through assisted reproductive technology such as IVF or IUI, result in miscarriage," says Dr. Varsha Patil, a well-known fertility expert. The number may sound shocking, but with the knowledge of the causes, risk factors, and preventive measures, the couple is given the clarity and confidence to proceed.What Is A Miscarriage?A miscarriage in medical terminology is the spontaneous loss of pregnancy before 20 weeks of gestation. In Dr. Patil's opinion, miscarriages can be generally divided into two broad categories—early miscarriage, which is a pregnancy loss before 13 weeks, and late miscarriage, which takes place between 13 to 20 weeks. Although it's easy to think that when women become pregnant after IVF, they've exceeded the most dangerous period, the truth is usually different. IVF pregnancies, which are thoroughly monitored, are not completely safe from complications. Actually, some factors underlying the case—like maternal age, embryo quality, uterine anomalies, and hormonal imbalance—can still lead to miscarriage despite a successful embryo transfer.What Causes Miscarriage After IVF?Miscarriages after IVF are generally not an indication of treatment failure but usually result from natural biological and physiological problems. Chromosomal abnormalities are one of the most frequent reasons for miscarriage irrespective of how pregnancy is achieved. "An embryo with the incorrect number of chromosomes is unlikely to survive," says Dr. Patil, pointing to the biological problem that can sideline even the best-planned IVF pregnancy. In addition to this, maternal health is also crucial—chronic diseases like uncontrolled diabetes, thyroid disturbances, kidney illness, and autoimmune diseases can disrupt a normal pregnancy and predispose to loss. Lifestyle factors are also very important.Cigarette smoking, alcohol use, illicit drug use, and even overuse of caffeine are all recognized risk factors for miscarriage. Dr. Patil reiterates that having IVF doesn't erase the need to make healthier lifestyle changes. Physical conditions like fibroids, polyps, a uterine septum, or an incompetent cervix can make it difficult to carry a pregnancy to term. Advanced age is another significant factor; women above 35 have a 25% or more chance of miscarriage, and for women aged above 40, this chance increases to more than 50%. In addition, serious anemia, malnutrition, and inadequate post-embryo transfer medical follow-up can adversely affect pregnancy and hence require holistic post-IVF care to ensure a successful process.How Age Can Affect Chances Of Miscarriage After IVF?Although age is a natural component of reproductive aging, it plays an extensive role in the success of IVF. Dr. Patil clarifies, "Between 20 and 35, the rate of miscarriage is 10–15%. But post 35, the rate increases significantly." This is partly because eggs from women who are older have a greater chance of chromosomal abnormalities.For individuals who are thinking about IVF later in life, this information underscores the value of genetic screening and preconception counseling to get the healthiest embryos to transfer.Role of Embryo QualityEmbryo quality is critical to the success of IVF—and to eliminating the risk of miscarriage. As Dr. Patil puts it, "A good quality embryo has a much lower risk of miscarriage than a poor quality one."Chromosomal information clarifies the different rates of miscarriage associated with the quality of the embryo.Research indicates that high-quality embryos suffer a miscarriage rate of about 13.3%, but low-quality embryos can suffer a much higher percentage, about 20%. This is where sophisticated reproductive procedures such as Preimplantation Genetic Testing for Aneuploidies (PGTA) are utilized. PGTA allows physicians to detect chromosomally normal (euploid) embryos prior to implantation, significantly enhancing the likelihood of a successful pregnancy while minimizing the risk of miscarriage. For couples who have gone through the devastation of miscarriage following IVF, the path ahead seems uncertain.How long, then, should one wait before attempting another pregnancy? In Dr. Patil's opinion, a waiting time of 2 to 3 months is what is usually advised. This window of time accommodates both emotional recovery and physical healing," she explains. It also allows fertility doctors to assess any underlying complications, fine-tune medication regimens, and perform any further medical procedures that are required. Sparing this time not only gets the body ready for another cycle, but it also enables couples to rejoin the process with fresh hope and knowledge-based support. Signs of Miscarriage Women Should Watch ForPregnancies that occur through IVF are normally closely monitored, but it's still important for women to remain vigilant for complications. Dr. Patil enumerates the following signs that may be a sign of miscarriage:Spotting or brownish dischargeModerate to heavy vaginal bleedingAbdominal cramps or lower back painSudden loss of pregnancy symptoms (such as nausea or breast tenderness)Fluid or tissue passing from the vaginaLack of fetal heartbeat or growth on ultrasoundIf any of these symptoms are noticed, immediate medical consultation is essential. "The sooner we take action, the greater opportunity we have to offer support or handle complications," she maintains.A miscarriage, be it following natural conception or IVF, is not merely a medical occurrence—though an emotional one. Dr. Patil forbids couples to blame themselves. "It's a natural aspect of the reproductive cycle, frequently as a result of factors nobody has control over."Support systems, counseling, and community groups may assist couples in dealing with sorrow in a positive way while remaining positive about the future. Significantly, a single miscarriage does not predict the next pregnancy to end similarly. With updated technologies, individualized fertility care, and psychological strength, numerous couples proceed to have healthy pregnancies following miscarriage.Whereas IVF provides access to parenthood for millions worldwide, it's also important to note that it does not entirely eliminate the threat of miscarriage. Elements such as age, the quality of the embryo, maternal health, and lifestyle all remain crucial in determining the success.What is still crucial, as Dr. Patil stresses, is educated optimism. "Couples must know about the risks but not be discouraged by them. With proper medical attention, emotional support, and healthy lifestyles, the journey to parenthood continues to hold hope."Dr Varsha Patil is a Fertility specialist at GarbhaGudi IVF Centre, Bengaluru in India