Current Clinical Options for Diagnosis and Treatment of Recurrent Spontaneous Abortion

Abstract

Recurrent spontaneous abortion is a health care concern occurring in 2-5% of couples' attempting to reproduce. The observed frequency of recurrent abortion is higher than that expected by chance (0.3%), which implies an underlying cause(s) contributing to the recurrent Effective treatment is needed for couples experiencing recurrent spontaneous abortion. Before effective treatment can be instituted, the cause of pregnancy loss must be determined. The underlying causes of recurrent spontaneous abortion are not entirely clear. As a result, controversy regarding the appropriate evaluation and treatment of couples experiencing recurrent spontaneous abortion ex'ists. To approach this controversy the American Society for Reproductive Immunology, under the direction of its President, Thomas J Gill, 111, established the committee on Clinical Guidelines Recommendation Committee for Recurrent Spontaneous Abortion in 1995. The members of the Committee were: Carolyn Coulam, Chairman; Alan Beer; William H. Kutteh; David A Clark; Robert Silver; Joanne Kwak; and Mary Stephenson. Each member was asked to submit guidelines for both diagnosis and treatment of recurrent spontaneous abortion. The guidelines were collated by the chairman and circulated to the members of the committee for additions and corrections. A final corrected report was recirculated to the committee members, and the committee met at the time of the 16th Annual Meeting of the American Society of Reproductive Immunology on June 23, 1996, in Knoxville, Tennessee, for a consensus conference. The final manuscript emerging from the consensus conference was given to the Council of the American Society for Reproductive Immunology for their consideration. Additions and corrections made by the council were incorporated into the report, and the report was recirculated to the new council and committee members before the Interim Executive Council Meeting on December 7, 1996, in Pittsburgh, Pennsylvania. The Committee presents options for diagnosis and treatment of recurrent spontaneous abortion. The Clinical Options for Diagnosis of Recurrent Spontaneous Abortion are based on an evaluation determined by risk factors of recent experimental and empirical research. Risk factors for recurrent spontaneous abortion in