The clinical management of repeated early pregnancy wastage

The process of fertilization is remarkably inefficient. Only a minority of conceptions progressively develop and result in a term birth. In fact, the earlier the gestation, the higher the rate of embryonic wastage. When pregnancy wastage is repetitive, intervention in the form of evaluation and therapy may be warranted. This report reviews the current literature, which relates to several etiologic factors (i.e., genetic, medical, immunologic, endocrine, psychogenic, environmental, occupational, infectious, and uterine) which have been noted to result in repeated pregnancy wastage. Where appropriate, suggestions for further clinical evaluation and management is offered, based on our interpretation of the state of the art.