Evaluation of recurrent miscarriage


Key articles

Royal College of Obstetricians and Gynaecologists. The investigation and treatment of couples with recurrent first-trimester and second-trimester miscarriage. April 2011 [internet publication].Full text

Jauniaux E, Farquharson RG, Christiansen OB, et al. Evidence-based guidelines for the investigation and medical treatment of recurrent miscarriage. Hum Reprod. 2006 Sep;21(9):2216-22.Full text  Abstract

European Society of Human Reproduction and Embryology (ESHRE) Special Interest Group for Early Pregnancy. Recurrent pregnancy loss. November 2017 [internet publication].Full text

Practice Committee of the American Society for Reproductive Medicine. Evaluation and treatment of recurrent pregnancy loss: a committee opinion. Fertil Steril. 2012 Nov;98(5):1103-11. Abstract

Reference articles

1. Practice Committee of American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss: a committee opinion. Fertil Steril. 2013 Jan;99(1):63. Abstract

2. Stirrat GM. Recurrent miscarriage. Lancet. 1990 Sep 15;336(8716):673-5. Abstract

3. Habayeb OM, Konje JC. The one-stop recurrent miscarriage clinic: an evaluation of its effectiveness and outcome. Hum Reprod. 2004 Dec;19(12):2952-8.Full text  Abstract

4. Quenby SM, Farquharson RG. Predicting recurring miscarriage: what is important? Obstet Gynecol. 1993 Jul;82(1):132-8. Abstract

5. Hennessy M, Dennehy R, Meaney S, et al. Clinical practice guidelines for recurrent miscarriage in high-income countries: a systematic review. Reprod Biomed Online. 2021 Jun;42(6):1146-71.Full text  Abstract

6. Brigham SA, Conlon C, Farquharson RG. A longitudinal study of pregnancy outcome following idiopathic recurrent miscarriage. Hum Reprod. 1999 Nov;14(11):2868-71.Full text  Abstract

7. Kleinhaus K, Perrin M, Friedlander Y, et al. Paternal age and spontaneous abortion. Obstet Gynecol. 2006 Aug;108(2):369-77. Abstract

8. Nguyen BT, Chang EJ, Bendikson KA. Advanced paternal age and the risk of spontaneous abortion: an analysis of the combined 2011-2013 and 2013-2015 National Survey of Family Growth. Am J Obstet Gynecol. 2019 Nov;221(5):476.e1-7. Abstract

9. du Fossé NA, van der Hoorn MP, van Lith JMM, et al. Advanced paternal age is associated with an increased risk of spontaneous miscarriage: a systematic review and meta-analysis. Hum Reprod Update. 2020 Sep 1;26(5):650-69.Full text  Abstract

10. Slama R, Bouyer J, Windham G, et al. Influence of paternal age on the risk of spontaneous abortion. Am J Epidemiol. 2005 May 1;161(9):816-23.Full text  Abstract

11. Regan L, Braude PR, Trembath PL. Influence of past reproductive performance on risk of spontaneous abortion. BMJ. 1989 Aug 26;299(6698):541-5.Full text  Abstract

12. Ogasawara M, Aoki K, Okada S, et al. Embryonic karyotype of abortuses in relation to the number of previous miscarriages. Fertil Steril. 2000 Feb;73(2):300-4. Abstract

13. Clifford K, Rai R, Watson H, et al. An informative protocol for the investigation of recurrent miscarriage: preliminary experience of 500 consecutive cases. Hum Reprod. 1994 Jul;9(7):1328-32. Abstract

14. Carp H, Feldman B, Oelsner G, et al. Parental karyotype and subsequent live births in recurrent miscarriage. Fertil Steril. 2004 May;81(5):1296-301. Abstract

15. Stephenson MD, Sierra S. Reproductive outcomes in recurrent pregnancy loss associated with a parental carrier of a structural chromosome rearrangement. Hum Reprod. 2006 Apr;21(4):1076-82.Full text  Abstract

16. Hogge WA, Byrnes AL, Lanasa MC, et al. The clinical use of karyotyping spontaneous abortions. Am J Obstet Gynecol. 2003 Aug;189(2):397-400. Abstract

17. Pasquier E, Bohec C, De Saint Martin L, et al. Strong evidence that skewed X-chromosome inactivation is not associated with recurrent pregnancy loss: an incident paired case-control study. Hum Reprod. 2007 Nov;22(11):2829-33. Abstract

18. Beever CL, Stephenson MD, Penaherrera MS, et al. Skewed X-chromosome inactivation is associated with trisomy in women ascertained on the basis of recurrent spontaneous abortion or chromosomally abnormal pregnancies. Am J Hum Genet. 2003 Feb;72(2):399-407.Full text  Abstract

19. Chan YY, Jayaprakasan K, Zamora J, et al. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum Reprod Update. 2011 Nov-Dec;17(6):761-71.Full text  Abstract

20. Grimbizis GF, Camus M, Tarlatzis BC, et al. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update. 2001 Mar-Apr;7(2):161-74.Full text  Abstract

21. Valli E, Vaquero E, Lazzarin N, et al. Hysteroscopic metroplasty improves gestational outcome in women with recurrent spontaneous abortion. J Am Assoc Gynecol Laparosc. 2004 May;11(2):240-4. Abstract

22. National Institute for Health and Care Excellence. Hysteroscopic metroplasty of a uterine septum for recurrent miscarriage. January 2015 [internet publication].Full text

23. Drakeley AJ, Roberts D, Alfirevic Z. Cervical stitch (cerclage) for preventing pregnancy loss in women. Cochrane Database Syst Rev. 2003 Jan;2003(1):CD003253.Full text  Abstract

24. Rai RS, Regan L, Clifford K, et al. Antiphospholipid antibodies and beta 2-glycoprotein-I in 500 women with recurrent miscarriage: results of a comprehensive screening approach. Hum Reprod. 1995 Aug;10(8):2001-5. Abstract

25. Royal College of Obstetricians and Gynaecologists. The investigation and treatment of couples with recurrent first-trimester and second-trimester miscarriage. April 2011 [internet publication].Full text

26. Jauniaux E, Farquharson RG, Christiansen OB, et al. Evidence-based guidelines for the investigation and medical treatment of recurrent miscarriage. Hum Reprod. 2006 Sep;21(9):2216-22.Full text  Abstract

27. Bates SM, Greer IA, Middeldorp S, et al; American College of Chest Physicians. VTE, thrombophilia, antithrombotic therapy, and pregnancy: antithrombotic therapy and prevention of thrombosis, 9th ed - American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012 Feb;141(2 Suppl):e691S-e736S.Full text  Abstract

28. Miyakis S, Lockshin MD, Atsumi T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006 Feb;4(2):295-306.Full text  Abstract

29. Rai R, Regan L. Recurrent miscarriage. Lancet. 2006 Aug 12;368(9535):601-11. Abstract

30. Wong LF, Porter TF, Scott JR. Immunotherapy for recurrent miscarriage. Cochrane Database Syst Rev. 2014;(10):CD000112.Full text  Abstract

31. Dosiou C, Giudice LC. Natural killer cells in pregnancy and recurrent pregnancy loss: endocrine and immunologic perspectives. Endocr Rev. 2005 Feb;26(1):44-62.Full text  Abstract

32. Robertson L, Wu O, Langhorne P, et al; Thrombosis: Risk and Economic Assessment of Thrombophilia Screening (TREATS) Study. Thrombophilia in pregnancy: a systematic review. Br J Haematol. 2006 Jan;132(2):171-96. Abstract

33. Preston FE, Rosendaal FR, Walker ID, et al. Increased fetal loss in women with heritable thrombophilia. Lancet. 1996 Oct 5;348(9032):913-6. Abstract

34. Arachchillage DJ, Mackillop L, Chandratheva A, et al. Thrombophilia testing: a British Society for Haematology guideline. Br J Haematol. 2022 Aug;198(3):443-58.Full text  Abstract

35. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins–Obstetrics. ACOG Practice Bulletin No. 197: Inherited thrombophilias in pregnancy. Obstet Gynecol. 2018 Jul;132(1):e18-34. Abstract

36. Cocksedge KA, Li TC, Saravelos SH, et al. A reappraisal of the role of polycystic ovary syndrome in recurrent miscarriage. Reprod Biomed Online. 2008 Jul;17(1):151-60. Abstract

37. The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004 Jan;19(1):41-7.Full text  Abstract

38. Craig LB, Ke RW, Kutteh WH. Increased prevalence of insulin resistance in women with a history of recurrent pregnancy loss. Fertil Steril. 2002 Sep;78(3):487-90. Abstract

39. Rai R, Backos M, Rushworth F, et al. Polycystic ovaries and recurrent miscarriage: a reappraisal. Hum Reprod. 2000 Mar;15(3):612-5.Full text  Abstract

40. Arredondo F, Noble LS. Endocrinology of recurrent pregnancy loss. Semin Reprod Med. 2006 Feb;24(1):33-9. Abstract

41. Haas DM, Hathaway TJ, Ramsey PS. Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology. Cochrane Database Syst Rev. 2019 Nov 20;2019(11):CD003511.Full text  Abstract

42. Coomarasamy A, Williams H, Truchanowicz E, et al. A randomized trial of progesterone in women with recurrent miscarriages. N Engl J Med. 2015 Nov 26;373(22):2141-8. Abstract

43. Coomarasamy A, Devall AJ, Brosens JJ, et al. Micronized vaginal progesterone to prevent miscarriage: a critical evaluation of randomized evidence. Am J Obstet Gynecol. 2020 Aug;223(2):167-76.Full text  Abstract

44. Dlugi AM. Hyperprolactinemic recurrent spontaneous pregnancy loss: a true clinical entity or a spurious finding? Fertil Steril. 1998 Aug;70(2):253-5. Abstract

45. Abalovich M, Gutierrez S, Alcaraz G, et al. Overt and subclinical hypothyroidism complicating pregnancy. Thyroid. 2002 Jan;12(1):63-8. Abstract

46. Prummel MF, Wiersinga WM. Thyroid autoimmunity and miscarriage. Eur J Endocrinol. 2004 Jun;150(6):751-5. Abstract

47. Mills JL, Simpson JL, Driscoll SG, et al. Incidence of spontaneous abortion among normal women and insulin-dependent diabetic women whose pregnancies were identified within 21 days of conception. N Engl J Med. 1988 Dec 22;319(25):1617-23. Abstract

48. Summers PR. Microbiology relevant to recurrent miscarriage. Clin Obstet Gynecol. 1994 Sep;37(3):722-9. Abstract

49. Hay PE, Lamont RF, Taylor-Robinson D, et al. Abnormal bacterial colonisation of the genital tract and subsequent preterm delivery and late miscarriage. BMJ. 1994 Jan 29;308(6924):295-8.Full text  Abstract

50. Matovina M, Husnjak K, Milutin N, et al. Possible role of bacterial and viral infections in miscarriages. Fertil Steril. 2004 Mar;81(3):662-9. Abstract

51. Pirtea P, Cicinelli E, De Nola R, et al. Endometrial causes of recurrent pregnancy losses: endometriosis, adenomyosis, and chronic endometritis. Fertil Steril. 2021 Mar;115(3):546-560.Full text  Abstract

52. McQueen DB, Zhang J, Robins JC. Sperm DNA fragmentation and recurrent pregnancy loss: a systematic review and meta-analysis. Fertil Steril. 2019 Jul;112(1):54-60.e3. Abstract

53. Yifu P, Lei Y, Shaoming L, et al. Sperm DNA fragmentation index with unexplained recurrent spontaneous abortion: A systematic review and meta-analysis. J Gynecol Obstet Hum Reprod. 2020 Apr 26;:101740. Abstract

54. European Society of Human Reproduction and Embryology (ESHRE) Special Interest Group for Early Pregnancy. Recurrent pregnancy loss. November 2017 [internet publication].Full text

55. Papas RS, Kutteh WH. A new algorithm for the evaluation of recurrent pregnancy loss redefining unexplained miscarriage: review of current guidelines. Curr Opin Obstet Gynecol. 2020 Oct;32(5):371-79.Full text  Abstract

56. Gardella JR, Hill JA 3rd. Environmental toxins associated with recurrent pregnancy loss. Semin Reprod Med. 2000;18(4):407-24. Abstract

57. Kline J, Shrout P, Stein Z, et al. Drinking during pregnancy and spontaneous abortion. Lancet. 1980 Jul 26;2(8187):176-80. Abstract

58. Signorello LB, McLaughlin JK. Maternal caffeine consumption and spontaneous abortion: a review of the epidemiologic evidence. Epidemiology. 2004;15:229-239. Abstract

59. Sata F, Yamada H, Suzuki K, et al. Caffeine intake, CYP1A2 polymorphism and the risk of recurrent pregnancy loss. Mol Hum Reprod. 2005 May;11(5):357-60.Full text  Abstract

60. Brent RL. The effects of embryonic and fetal exposure to x-ray, microwaves, and ultrasound. Clin Perinatol. 1986 Sep;13(3):615-48. Abstract

61. National Institute for Health and Care Excellence. Ectopic pregnancy and miscarriage: diagnosis and initial management. November 2021 [internet publication].Full text

62. Barnhart KT, Sammel MD, Rinaudo PF, et al. Symptomatic patients with an early viable intrauterine pregnancy: HCG curves redefined. Obstet Gynecol. 2004 Jul;104(1):50-5. Abstract

63. Royal College of Obstetricians and Gynaecologists. Diagnosis and management of ectopic pregnancy. Green-top guideline no. 21. November 2016 [internet publication].Full text

64. Kim C, Barnard S, Neilson JP, et al. Medical treatments for incomplete miscarriage. Cochrane Database Syst Rev. 2017 Jan 31;1:CD007223.Full text  Abstract

65. Bradley LA, Palomaki GE, Bienstock J, et al. Can Factor V Leiden and prothrombin G20210A testing in women with recurrent pregnancy loss result in improved pregnancy outcomes?: Results from a targeted evidence-based review. Genet Med. 2012 Jan;14(1):39-50. Abstract

66. Practice Committee of the American Society for Reproductive Medicine. Evaluation and treatment of recurrent pregnancy loss: a committee opinion. Fertil Steril. 2012 Nov;98(5):1103-11. Abstract

67. Royal College of Obstetricians and Gynaecologists. The role of natural killer cells in human fertility. Scientific impact paper no. 53. December 2016 [internet publication].Full text

68. Foyouzi N, Cedars MI, Huddleston HG. Cost-effectiveness of cytogenetic evaluation of products of conception in the patient with a second pregnancy loss. Fertil Steril. 2012 Jul;98(1):151-5. Abstract

69. Bernardi LA, Plunkett BA, Stephenson MD. Is chromosome testing of the second miscarriage cost saving? A decision analysis of selective versus universal recurrent pregnancy loss evaluation. Fertil Steril. 2012 Jul;98(1):156-61. Abstract

70. Dhillon RK, Hillman SC, Morris RK, et al. Additional information from chromosomal microarray analysis (CMA) over conventional karyotyping when diagnosing chromosomal abnormalities in miscarriage: a systematic review and meta-analysis. BJOG. 2014 Jan;121(1):11-21.Full text  Abstract

71. Platteau P, Staessen C, Michiels A, et al. Preimplantation genetic diagnosis for aneuploidy screening in patients with unexplained recurrent miscarriages. Fertil Steril. 2005 Feb;83(2):393-7. Abstract

72. Audibert F, Wilson RD, Allen V, et al. Preimplantation genetic testing. J Obstet Gynaecol Can. 2009 Aug;31(8):761-75. Abstract

73. ESHRE Capri Workshop Group. Genetic aspects of female reproduction. Hum Reprod Update. 2008 Jul-Aug;14(4):293-307.Full text  Abstract

74. Brocklehurst P, Gordon A, Heatley E, et al. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD000262.Full text  Abstract

75. Queensland Health. Queensland clinical guidelines: maternity and neonatal clinical guidelines. Early pregnancy loss. Oct 2022 [internet publication].Full text

76. Saravelos SH, Cocksedge KA, Li TC. Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum Reprod Update. 2008 Sep-Oct;14(5):415-29. Abstract

77. Grimbizis GF, Di Spiezio Sardo A, Saravelos SH, et al. The Thessaloniki ESHRE/ESGE consensus on diagnosis of female genital anomalies. Hum Reprod. 2016 Jan;31(1):2-7.Full text  Abstract

78. Crane JM, Hutchens D. Transvaginal sonographic measurement of cervical length to predict preterm birth in asymptomatic women at increased risk: a systematic review. Ultrasound Obstet Gynecol. 2008 May;31(5):579-87. Abstract

Use of this content is subject to our disclaimer