Can balanced translocation cause miscarriage?

Yes — this is the most common way translocations come to light. The mechanism: when eggs or sperm form, the rearranged chromosomes can separate unevenly, producing embryos with too much or too little chromosomal material. Most such embryos either fail to implant or miscarry in the first trimester. Balanced structural rearrangements are found in a small percentage of couples investigated for recurrent pregnancy loss. That percentage is low, which is why testing has become more targeted. ASRM (2026) recommends parental karyotyping be offered when chromosome testing of a miscarriage shows an unbalanced structural rearrangement, or where no chromosome testing of miscarriages is available — rather than testing every couple routinely. That reflects a shift in approach worth understanding: chromosome analysis of the miscarriage tissue itself is now recommended as the first step. If a loss is found to be due to a sporadic chromosome error, that explains it and further investigation is often unnecessary. If an unbalanced rearrangement is found, that points directly to parental testing. Something important if a translocation is found in your case: it does not mean you cannot have children. Live birth rates as high as 70 to 71% without assisted reproduction have been reported in translocation carriers. And it does not mean the losses were your fault. This is a structural feature you were born with and could not have known about or prevented.