Hi, Missed abortion, also known as silent miscarriage, occurs when the embryo or fetus dies but is not expelled from the uterus. It can happen for a variety of reasons, including chromosomal abnormalities, infections, hormonal imbalances, and problems with the uterus or cervix. In your case, since the ultrasound report showed missed abortion and threatened abortion, there may be an underlying genetic or chromosomal issue. Therefore, your doctor s suggestion to go for a karyotype test is appropriate. This test involves analyzing the chromosomes of both you and your wife to see if any abnormalities could be contributing to the miscarriages. Other possible causes of missed abortion include certain medical conditions, such as thyroid disorders or autoimmune diseases, as well as lifestyle factors like smoking, alcohol consumption, and obesity. However, these factors would typically not be associated with a pattern of repeated miscarriages like in your wife s case. It is also important to note that sometimes the cause of miscarriage is not identified. However, your doctor will likely perform additional tests and evaluations to rule out any possible causes and determine the best course of action. It is recommended that you and your wife have a thorough discussion with your doctor about the possible causes of missed abortion and the appropriate steps to take. Your doctor may suggest waiting for a few months before trying to conceive again or may recommend further testing or treatment options, such as hormone therapy or surgery, depending on the underlying cause. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Priyanka, General & Family Physician