ABSTRACT
Couples with recurrent miscarriage are fertile as, by denition, they will have experienced at least three consecutive miscarriages. Some, however, have coexistent subfertility, so the repeated loss of long-awaited pregnancies adds to the trauma that they have already experienced. The overall risk of miscarriage of clinically recognised pregnancies is between 15% and 25% and remains similar for women who have had any number of live born children, although total reproductive losses are closer to 50% [1]. After one miscarriage, the risk of another miscarriage has been estimated as approximately 23%; after two consecutive miscarriages, this number increases to 29% and after three the risk is approximately 33% if a cause if found. In cases of idiopathic recurrent miscarriage, the risk of a further miscarriage is 25% [2]. The risk of a second miscarriage after one or more live births is 20%–25%. The majority of women who miscarry once, or even twice, after fertility treatment can be reassured that there is unlikely to be an underlying cause. Relatively few couples (approximately 1%) will experience recurrent miscarriages, and they should be investigated further. It has been calculated that the chance of three consecutive miscarriages is 0.34%, lower than the observed rate of recurrent miscarriage, suggesting the possibility of an underlying cause [3].
