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Evaluation and Management of Recurrent Early Pregnancy Loss


Clinical Obstetrics and Gynecology: March 2007 - Volume 50 - Issue 1 - p 132-145
doi: 10.1097/GRF.0b013e31802f1c28
First Trimester Pregnancy Complications

Recurrent pregnancy loss affects up to 5% of couples trying to establish a family. Evaluation classically begins after 3 consecutive miscarriages of less than 10 weeks of gestation but may be warranted earlier if a prior miscarriage was found to be euploid, or if there is concomitant infertility and/or advancing maternal age. The evaluation begins with an extensive history and physical, followed by a diagnostic screening protocol. Management must be evidence-based; unproven treatments should be avoided. If no factor is identified, many couples will still eventually have a successful pregnancy outcome with supportive therapy alone.

*Section of Reproductive Endocrinology and Infertility, University of Chicago, Chicago, Illinois

Recurrent Pregnancy Loss Program, University of Chicago Hospitals, Chicago, Illinois

University of Tennessee Health Sciences Center at Memphis, Memphis, Tennessee

Correspondence: Dr Mary Stephenson, MD, MSc, University of Chicago, 5841 South Maryland Avenue (MC 2050), Chicago, IL 60637. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.