Abstract
Recurrent miscarriage is defined as the loss of three consecutive pregnancies before
20 weeks' gestational age. Patients are referred to subspecialists such as reproductive
endocrinology or maternal fetal medicine to exclude the most common causes of recurrent
miscarriage including autoimmune disorders, structural uterine pathology, metabolic
derangements, hematologic conditions, and chromosomal abnormalities. Unfortunately,
this extensive list of conditions accounts for less than 50% of patients affected
by recurrent miscarriage, leaving the remaining 50% without answers. Multiple treatment
modalities, including supplementation with progesterone, human chorionic gonadotropin,
aspirin with and without heparin, and immune modulators have been tested for this
large percentage of patients with very few answers. In fact, the only successful intervention
addressed in the literature consists of supportive care at a dedicated recurrent miscarriage
clinic. Without large randomized clinical trials, there is no evidence to support
the use of supplemental medications in this patient population.
Keywords
recurrent miscarriage - unexplained miscarriage - miscarriage without diagnosis -
treatment for recurrent miscarriage
