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Abstract
Many human conceptions are genetically abnormal and end in miscarriage, which is the
commonest complication of pregnancy. Recurrent miscarriage, the loss of three or more
consecutive pregnancies, affects 1% of couples trying to conceive. It is associated
with psychological morbidity, and has often proven to be frustrating for both patient
and clinician. A third of women attending specialist clinics are clinically depressed,
and one in five have levels of anxiety that are similar to those in psychiatric outpatient
populations. Many conventional beliefs about the cause and treatment of women with
recurrent miscarriage have not withstood scrutiny, but progress has been made. Research
has emphasised the importance of recurrent miscarriage in the range of reproductive
failure linking subfertility and late pregnancy complications and has allowed us to
reject practice based on anecdotal evidence in favour of evidence-based management.