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Recurrent Miscarriage, Investigation and Treatment of Couples (Green-top Guideline No. 17)

Published: 19/05/2011

This is the third edition of this guideline, which was first published in 1998 and then in 2003 under the title The Investigation and Treatment of Couples with Recurrent Miscarriage.

Update February 2017: Following a review of all guidelines in December 2016, some minor editorial changes have been made to this guideline since the original publication. The version available here is the most up to date. The date on the guideline has not been changed since no amendments were made to the content.

Update December 2014: New evidence and guidance in this field were reviewed in 2014 and it was decided that revision of this guideline would be deferred to a later date. The version available on the website and app will remain valid until replaced.

Miscarriage is defined as the spontaneous loss of pregnancy before the fetus reaches viability. The term therefore includes all pregnancy losses from the time of conception until 24 weeks of gestation. It should be noted that advances in neonatal care have resulted in a small number of babies surviving birth before 24 weeks of gestation.

Recurrent miscarriage, defined as the loss of three or more consecutive pregnancies, affects 1% of couples trying to conceive. It has been estimated that 1–2% of second-trimester pregnancies miscarry before 24 weeks of gestation.

The purpose of this guideline is to review the literature and provide guidance on the investigation and treatment of couples with recurrent miscarriage.