Cause Of Recurrent Miscarriage Research Articles

Progesterone supplementation in women with otherwise unexplained recurrent miscarriages

CONTEXT:Recurrent miscarriages, the loss of three or more consecutive intrauterine pregnancies before 20 weeks of gestation with the same partner, affect 1%–1.5% of the pregnant population. The inadequate secretion of progesterone in early pregnancy has been proposed as a cause of recurrent miscarriages.AIMS:The aim was to investigate the efficacy of progesterone supplementation in patients with unexplained recurrent miscarriages.SETTINGS AND DESIGN:This was a 9-year cohort study of women with otherwise unexplained recurrent miscarriages who attended a recurrent miscarriage clinic in a tertiary care university hospital.SUBJECTS AND METHODS:Women with at least three unexplained recurrent miscarriages were included in the study. They were divided into three groups according to their initial and 48-h repeat progesterone levels. For women with inadequate endogenous progesterone secretion, natural progesterone vaginal pessaries 400 mg 12-hourly were offered until 12 weeks gestation.STATISTICAL ANALYSIS:Proportions and 95% confidence intervals calculated for categorical variables and the chi-square test were used to show statistical significance. Medians and ranges were calculated for noncontinuous variables.RESULTS:Pregnancy cycles (n = 203) were analyzed to examine the miscarriage rate following progesterone supplementation. Overall live birth and miscarriage rates were 63% and 36%, respectively. When analyzed by the number of previous miscarriages there was a reduction in the miscarriage rate following progesterone supplementation in women with 4 previous miscarriages when compared with historical data.CONCLUSIONS:Progesterone supplementation may have beneficial effects in women with otherwise unexplained recurrent miscarriages.

Reciprocal balanced translocation: infertility and recurrent spontaneous abortions in a family

In this case report we present a family with infertile, azoospermic but otherwise apparently healthy males with history of recurrent spontaneous abortions (RSA) in females. Karyotype of the infertile man revealed a reciprocal balanced translocation t(8; 13) with breakpoints at 8q22 and 13p11.2. The reported reciprocal balanced translocation is associated with azoospermia. The same translocation is probably the cause of RSA in females of the family.

Coding region polymorphisms in the indoleamine 2,3-dioxygenase (INDO) gene and recurrent spontaneous abortion

Indoleamine 2,3-dioxygenase (INDO) catalyzes degradation of the indole ring of indoleamines and locally depletes tryptophan. INDO expression suppresses T cell proliferation and activation. Genetic variation in the INDO gene may contribute to the variable INDO enzyme expression, activity and severity of some diseases. Recurrent spontaneous abortion (RSA) is a common pregnancy complication and the exact causes of RSA are not yet known. We performed an association study between INDO single nucleotide polymorphisms (SNPs) and RSA. To identify INDO SNPs we sequenced DNA samples for ten exons and adjacent intronic regions from 111 RSA patients. Consequently 10 SNPs were detected; four in exons (one in exon 4, two in exon 9 and one in exon 10) and six in intronic regions (one in intron 3, three in intron 6, one in intron 8 and one in intron 9). Three (IVS3+562 del C, IVS8+116 T→G and IVS9+2431 G→A) of these ten SNPs have been registered at the NCBI SNP database. Statistical analysis of allele, genotype and haplotype frequency distribution in the three most frequent SNPs (IVS3+562 del C, IVS6+61 G→A and IVS9+2431 G→A) showed no significant differences between the 111 RSA and 105 matched control women. CGA and CGG were the most frequent haplotypes in both the RSA and control groups. We conclude that there is no association between INDO polymorphisms and susceptibility of Iranian women to RSA.

Genetic Factors as a Cause of Miscarriage

Aneuploidy in the conceptus or fetus, occurs in 5-10% of all pregnancies and is a common reproductive problem in humans. Most aneuploid conceptuses die in utero, resulting in early pregnancy loss. Causes of recurrent miscarriage may include abnormal chromosomes in either partner, particularly translocations, antiphospholipid antibodies and uterine anomalies. Chromosomal aberrations in parents are a major pre-disposing factor and causative of abortion if carried over to the embryo. The transmission rate in the embryo can be speculated to be about 50%. Embryo morphology, developmental rates, and maternal age are correlated with chromosomal abnormalities. Translocation in either partner is one of the most important causes of recurrent miscarriage and the prognosis of subsequent pregnancy in couples with abnormal embryonic karyotype is poorer than that in couples with normal chromosome karyotypes. As for parents whose karyotypes are normal, the frequency of normal embryonic karyotypes significantly increases with the number of previous abortions and a normal karyotype in a previous pregnancy is a predictor of subsequent miscarriage. Recently, many kinds of genetic polymorphisms have also been found to be associated with recurrent miscarriages. In contrast, preimplantation genetic diagnosis for aneuploidy screening is sometimes performed in patients with unexplained recurrent miscarriages. We review genetic factors as a cause of miscarriage.

Y chromosome microdeletions, sperm DNA fragmentation and sperm oxidative stress as causes of recurrent spontaneous abortion of unknown etiology

The aim of the present study was to evaluate the implication of male factor, in terms of sperm DNA oxidation and fragmentation, and Y chromosome microdeletions in recurrent spontaneous abortion (RSA) of unknown origin in a strictly selected cohort. A prospective cohort study was carried out in a private university-affiliated setting. Three groups, each comprised of 30 males, were compared. The first was formed by healthy and fertile sperm donors (SD) with normal sperm parameters (control group), the second by men presenting severe oligozoospermia (SO) without RSA history, and the third by men from couples who had experienced idiopathic RSA. Frequency of Y chromosome microdeletions and mean sperm DNA fragmentation and oxidation were determined. Y chromosome microdeletions were not detected in any of the males enrolled in the study. Moreover, sperm DNA oxidation measurements were not demonstrated to be relevant to RSA. Interestingly, sperm DNA fragmentation was higher in the SO group than in the RSA and the SD groups, and also higher in the RSA group compared with the SD group, but lacked an adequate predictive power to be employed as a discriminative test of RSA condition. Sperm DNA features and Y chromosome microdeletions do not seem to be related to RSA of unknown origin. Other molecular features of sperm should be studied to determine their possible influence on RSA. Clinicaltrials.gov reference: NCT00447395.

Molecular cytogenetic analysis by genomic hybridization to determine the cause of recurrent miscarriage

To characterize a t(2;6) by array-based comparative genomic hybridization (array-CGH) in a couple with recurrent miscarriage, to analyze the meiotic segregation of the t(2;6), and to discuss couple specific care-taking modality before intracytoplasmic sperm injection. Case report. INSERM U613 in Brest, France. Couple consulting for infertility. Array-CGH to characterize a t(2;6) and fluorescence in situ hybridization (FISH) to analyze the meiotic segregation were performed. Array-CGH, FISH with a panel of bacterial artificial chromosome clones and commercial probes. Analyses from peripheral blood lymphocytes identified a t(2;6)(q35;q24) unbalanced reciprocal translocation with microdeletions on the der(2) and the der(6). FISH on spermatozoa found that the frequency of normal (23,X or 23,Y) or "translocation-deletions" (23,X,der(2),der(6) or 23,Y,der(2),der(6)) spermatozoa was 41.10%. For our 46,XY,t(2;6)(q35;q24) carrier, more than 50% of the spermatozoa are chromosomally unbalanced. Moreover, FISH does not permit a distinction between normal and "translocation-deletion" phenotypes. So, in the possibility of preimplantation genetic diagnosis, is it necessary to select the normal embryos to the detriment of those translocation-deletions carriers? The pathogenicity of these microdeletions not been proved. Because the family history was oriented toward a variation of genetic equipment without phenotypic consequences, the couple decided not to make a selection between the normal embryos and the translocation-deletion carrier embryos.

The pattern of pregnancy loss in women with congenital uterine anomalies and recurrent miscarriage

Congenital uterine anomalies (CUA) are a known cause of recurrent miscarriage (RM), but the pattern of pregnancy loss that different CUA produce remains unknown. This study included 665 women with RM who were screened for CUA using a combined two-dimensional ultrasound (2D-US) and hysterosalpingography (HSG) approach. All suspected CUA were definitively diagnosed and classified via a combined hysteroscopy/laparoscopy procedure. Pregnancy outcomes were evaluated and compared for each type of CUA versus a control group of women with no identifiable cause of RM (unexplained RM). Fifty-six women with CUA and 107 women with unexplained RM were identified. In total, 881 pregnancies were analysed. Analysis showed that women with a septate or bicornuate uterus suffered from significantly increased second-trimester miscarriages compared with controls (13.2% and 13.8% versus 1.0%; P<0.001 and P<0.05, respectively). Women with an arcuate, septate or bicornuate uterus showed significantly reduced rates of biochemical pregnancy losses compared with controls (9.5%, 11.1% and 11.1% versus 30.4%; P<0.01, P<0.01 and P<0.05, respectively). Pregnancies of women with RM and CUA are not associated with early implantation failure and are compromised at a more advanced gestational age.

How common is polycystic ovary syndrome in recurrent miscarriage?

The association between polycystic ovary syndrome (PCOS) and recurrent miscarriage (RM) has been long established, but the relative importance of this condition as a cause of RM is far from clear. Previous studies on the prevalence of PCOS in RM have been hampered by a lack of objective and universally accepted criteria for the diagnosis of PCOS, resulting in considerable controversy. However, the Rotterdam criteria have since been accepted as the gold standard for diagnosis of PCOS, and therefore these criteria have been used to produce a much clearer and more objective assessment of the prevalence of PCOS in RM. Three hundred women with recurrent miscarriage were studied. A diagnosis of PCOS was established via measurement of cycle length and day 21 serum progesterone, determination of the free androgen index and pelvic ultrasonography. All ultrasound reports prior to publication of the Rotterdam criteria were reviewed, ensuring consistency in the diagnosis of a polycystic ovary. Ultrasound scans of 27 patients confirmed polycystic ovaries with a further 10 scans suggestive of polycystic ovaries, but with insufficient information for the Rotterdam criteria to be applied. Hence, 27-37 (9.0-12%) patients presented with ultrasonographic polycystic ovaries. Using the Rotterdam criteria, 25-30 (8.3-10%) patients had PCOS. It is concluded that the prevalence of PCOS in RM is considerably lower than has previously been accepted.

Diagnosis and treatment methods for recurrent miscarriage cases.

Recurrent miscarriage is classically defined as three or more consecutive pregnancy losses. Established causes of recurrent miscarriage are antiphospholipid antibodies, uterine anomalies and abnormal chromosomes in either partner, particularly translocations. Embryonic aneuploidy is the most important cause of miscarriage before 10 weeks' gestation. It can be speculated that about 51% of patients with a history of three miscarriages experienced these because of abnormal embryonic karyotypes. It is not necessary to give any medication for such cases caused by an abnormal embryonic karyotype. Psychological tender loving care might be the most important requirement to continue conceiving till live birth results.

ORIGINAL ARTICLE: Activating Killer Cell Immunoglobulin‐Like Receptor Genes’ Association with Recurrent Miscarriage

Problem Natural killer (NK) cells are regulated through NK cell receptors such as killer cell immunoglobulin‐like receptors (KIRs). KIRs are suspected of being involved in the causes of recurrent miscarriage (RM) as a higher proportion of activated NK cells were observed in women with RM when compared with that in controls. The aim of this study was to investigate if KIR genes coding for receptors known to have as ligands HLA class I molecules are correlated with RM.Method of study A matched case–control study was carried out in 68 south Brazilian Caucasian patient couples with RM and 68 control fertile couples. KIR genes were typed by PCR‐Reverse SSO method.Results The rate of possession of an elevated number of activating KIR genes (positive for five or six activating KIR genes out of six different activating KIR genes analyzed) in RM patient women was significantly higher (P = 0.0201) when compared with that in control fertile women. These data suggest that women carrying a high content of activating KIR genes have about threefold increased probability to develop RM [OR = 2.71; 95% CI (1.23–6.01)].Conclusion Our results indicate that RM could be associated with NK cell activation mediated by a profile rich in activating KIR genes.

Do mitochondrial mutations cause recurrent miscarriage?

The cause of recurrent miscarriage (RM) can be identified in approximately 50% of cases, whereas in others, unknown genetic factors are actively being sought. As mitochondrial functions, and therefore also the mitochondrial genome [mitochondrial DNA (mtDNA)], have an important role in human development, through ATP production and participation in apoptosis, we aimed to study the role of mtDNA variations in RM. We screened 48 women with RM and 48 age-matched control women for heteroplasmic mitochondrial mutations using denaturing high performance liquid chromatography, a sensitive method that can detect approximately 5% heteroplasmy. As a result, we detected a heteroplasmic mtDNA variation in 13 RM women (27%) and in 9 control women (19%). Seven synonymous and five non-synonymous changes were detected within coding regions. In addition, seven heteroplasmic variations were detected within the non-coding control region. We were also able to show the presence of the variations in eight placental samples from three heteroplasmic women. In three of these cases, the proportion of variant mtDNA was higher in the placenta compared with that in the mother. We conclude that our sensitive methodology revealed a higher frequency of samples with heteroplasmic variations than expected in women with both RM and controls. However, no apparent increased frequency of heteroplasmic mtDNA variations or amounts of aberrant mtDNA was detected in the RM group. In addition, none of the detected variations were previously known to be pathogenic and therefore they are an unlikely cause of miscarriage.

Cytogenetic studies in couples with recurrent miscarriage in the Sultanate of Oman

Miscarriage, defined as spontaneous pregnancy loss at <20-28 weeks' gestation, is a common clinical problem. Balanced chromosomal rearrangements in either parent are an important cause of repeated pregnancy loss, particularly in the first trimester. In this study, chromosomal abnormalities that cause recurrent miscarriage were evaluated in Omani parents and some of their dysmorphic children. A total of 380 couples (760 individuals) with two or more recurrent miscarriages were examined for chromosomal aberrations during the period 1999-2006. For each proband the chromosomal preparations were analysed and karyotyped after applying a Giemsa-trypsin banding method. The overall incidence of chromosomal anomaly was 26 out of 760 individuals (3.42%). These abnormalities included 21 (2.8%) structural aberrations and 5 (0.7%) numerical anomalies. In addition to these abnormalities, 39 (5.1%) chromosomal variants were also found. The nature of these abnormalities and their relation to obstetric history are discussed. In conclusion, chromosomal abnormality is one of the causes of recurrent miscarriage. This study illustrates the incidence and distribution of chromosomal abnormalities among Omani couples with recurrent miscarriage. Cytogenetic findings could provide valuable information for genetic counselling and allow monitoring of future pregnancies by prenatal diagnosis in couples with a history of recurrent miscarriage.

Limiting dilution analysis of the allo-MHC anti-paternal cytotoxic T cell response. II: Recurrent spontaneous abortion and the effect of immunotherapy.

Using limiting dilution analysis (LDA) we determined anti-paternal cytotoxic T lymphocyte precursor (CTLp) frequencies in the peripheral blood of 10 women with unexplained recurrent spontaneous abortion (RSA) before and after immunization with paternal lymphocytes. The women and their partners were HLA tissue-typed and none of the women had anti-paternal cytotoxic antibodies (APCA) before immunization. All other known causes of RSA were excluded. All 10 women were found to have high frequencies of specific anti-paternal cytotoxic T cells before immunization (range 1/1030 to 1/9574). Splitwell analysis showed that these cytotoxic cells were specific to paternal MHC antigens. These frequencies rose significantly following immunization (range 1/683 to 1/4652). The cytotoxic T lymphocyte frequencies against an HLA-mismatched third party varied from woman to woman, but were not affected by the immunization. The LDA data conformed to single-hit kinetics, indicating that only cytotoxic T cells were limiting in the assay. Our data are in sharp contrast to the previously held view that women with RSA may be hyporesponsive to paternal MHC antigens. Immunizing such women with paternal leucocytes further sensitizes them. These findings cannot be reconciled with a favourable outcome in the treatment of RSA with immunotherapy. We would argue that this treatment is at best of unproven value, and may even be harmful. That these women may sometimes have successful pregnancies following immunotherapy testifies to the effectiveness of the classical MHC antigen-deficient trophoblast as an immunological barrier between mother and fetus.

Effect of Gluten-Free Diet on Pregnancy Outcome in Celiac Disease Patients with Recurrent Miscarriages

Available literature data show that celiac disease (CD) is a frequent cause of recurrent miscarriage. However, data are lacking for pregnancy outcome when the patient is on a gluten-free diet (GFD). A case-control study about the effect of GFD on pregnancy was conducted from 1995 to 2006. A cohort of 13 women (mean age 32 years, range 22-38 years) affected by CD with recurrent miscarriages was observed. In all of them several causes of miscarriage (gynecological, endocrine, hematological, etc.) were excluded. All patients were started on a gluten-free diet and were reassessed throughout a long-term follow-up period to evaluate the outcome of pregnancy. Six of 13 became pregnant (46.15%) as follows: 1 patient (7.69%) 1 year after GFD was started, 3 patients (23.07%) 2 years after GFD was started, 1 patient (7.69%) after 3 years, and finally 1 (7.69%) 4 years after GFD was started. Moreover, two patients (16.66%) had multiple pregnancies (one had had two childbirths and another had undergone three births within a 7-year follow-up period under GFD). GFD seems to favor a positive outcome of pregnancy in most CD patients with recurrent miscarriage.

The Role of IL-2 and rheumatoid factor in recurrent spontaneous abortion

3 Abstract: It has been postulated that of repeated pregnancy losses in part may be due to immune causes. This research was carried out as case control study on fifty-six women with three or more RSA history (Group I) and sixty-three healthy women who have had no abortion history (Group II). Sera were examined for the presence of IL-2 and RF. Two out of 56 women in group I had IL-2 in serum. None of the women in group II showed IL-2 in serum. Also, 53.5% women in group I and 6.4% women in group II were positive for RF in different titers (P=0.002). Our finding shows that serum IL-2 concentration dose not affects pregnancy outcome. We recommend that the role of RF in pregnancy outcome should be considered. Recurrent spontaneous abortions (RSA) are still a This research was carried out as case control study frequent reproductive problem worldwide, with three or on two different groups referred to Yazd Research and more affecting 1% to 2% of women of reproductive age Clinical Centre for Infertility. Group I consisted of fifty-six (1). Despite several well established etiologic factors, the women with three or more RSA history and group II cause of RSA cannot be determined in almost 50% of the consisted of sixty-three healthy women who have had no cases. It has been postulated that a part of these repeated abortion history with at least one successful pregnancy. pregnancy losses may be related to immune causes (2). Aborter samples were normal in karyotype, TORCH The response of T helper (Th) cells following activation negative and had no anatomical or endocrine problems. is characterized functionally according to the cytokines All cases were primary RSA. Blood samples (5 ml) was they produce. Th1 cells secrete mainly interleukin (IL)-2, collected and as well as information for variables such as interferon (IFN)- and tumor necrosis factor (TNF)- (3). age, number of abortions, gestational age at the last IL-2 figures prominently among cytokines that are abortion for RSA women, also number of pregnancy for particularly determined to the survival of the conceptus. control women were provided The Local Institutional The administration of IL-2 into the pregnant mice causes Review Board approved the experimental procedures, and abortion (4). Rhumatoid Factors (RF) is antibodies that signed informed consent was obtained from each recognize the Fc portion of IgG molecules as their woman. Sera were examined for the presence of IL-2 antigens; RFs can be of any immunoglobulin isotype according to manufacture's instructions (Bender (IgM, IgG, IgE). Most of the RFs measured clinically are medsystem GmbH, Vienna, Austeria). The sensivity of IgM RFs (5). In the general (health) population, the IL-2 assay was 3.5Pg ml . RF (anti-human frequency of RF positive individuals ranges from 1.3-4% immunoglobulin) was determined by latex agglutination in Caucasians to 30% in some tribes of North Americans test and the presence of agglutination was considered Indians (6). The small subset of B cells that express CD5 positive. known as B-1a cells, appear to produce RF (7). Many studies have illustrated the essential role of T cells in the RESULTS

Treatment options and pregnancy outcome in women with idiopathic recurrent miscarriage: a randomized placebo-controlled study.

To compare the use of enoxaparin alone with combination therapy of prednisone, aspirin and progesterone in the treatment of women with idiopathic recurrent miscarriage (IRM) in terms of live births and pregnancy outcome. A prospective, randomized, single-blinded, placebo-controlled trial was conducted at a tertiary referral obstetric hospital. The participants were 170 women with a diagnosis of IRM. Women were recruited after full investigative screening. Women with > or =3 fetal losses and after exclusion of all known causes of recurrent miscarriage were randomly allocated to receive either enoxaparin alone, combination treatment consisting of prednisone, aspirin, and progesterone or placebo. Rates of live births, antenatal complications, delivery and neonatal outcomes were recorded prospectively. Data were statistically analyzed as appropriate. Ten patients were dropped out after random assignment. Eighty-one percent of the enoxaparin (46/57) group and 85% of the combination-treated group (45/53) were delivered of live infants compared to 48% (24/50) of the placebo (P < 0.05). Women who were treated with combination therapy had a 4.2% higher live birth rate than enoxaparin group. This difference was not significant. Miscarriage rates were significantly lower in the treated groups compared with placebo (P < 0.05). There were no significant differences in late obstetric complications or neonatal mortality between groups. A combination treatment consisting of high-dose, low-duration prednisone, progesterone and aspirin might be an effective treatment as enoxaparin alone. Both regimens were associated with a good pregnancy outcome.

Lupus anticoagulant and antibodies to β2-glycoprotein I, annexin V, and cardiolipin as a cause of recurrent spontaneous abortion

The prevalence of lupus anticoagulant (LAC), anticardiolipin (ACA), anti-beta(2) glycoprotein I (beta(2)GPI), and antiannexin V antibodies were determined in 200 recurrent spontaneous abortion (RSA) patients and 200 age-matched control women. ACA IgG was associated with early, while antiannexin V IgG and LAC were associated with late, and ACA IgG, antiannexin V IgG, and LAC were associated with combined early + late RSA, thereby recommending inclusion of their screening in RSA workout.

Midluteal phase Doppler assessment of uterine artery blood flow in nonpregnant women having a history of recurrent spontaneous abortions: correlation to different etiologies

To compare the impedance to uterine artery blood flow, during the midluteal phase, in women with recurrent spontaneous abortion (RSA) as compared to normal fertile controls. A prospective study involving women with a history of RSA and fertile controls. University of Rome "Tor Vergata." Two hundred thirty women with RSA and 50 fertile controls referred for routine examination. Transvaginal Doppler examination of uterine arteries during the midluteal phase of untreated cycles. The mean pulsatility index (PI) of uterine arteries. Uterine arteries PI values in RSA patients (2.42 +/- 0.79) were significantly higher with respect to those found in the control group (2.08 +/- 0.47). When patients were grouped according to the different RSA causes, the highest PI values were found among patients with uterine abnormalities (2.82 +/- 1.0), antiphospholipid antibodies syndrome (2.70 +/- 1.1), and unexplained RSA (2.60 +/- 0.7). These values were significantly higher with respect to that found in the control group. No differences were observed in PI values between fertile patients and those with RSA due to thyroid abnormalities (2.10 +/- 0.55), inherited thrombophilia (2.03 +/- 0.45), autoimmune pathology (2.34 +/- 1.18), and genetic anomalies (2.47 +/- 0.54). Similar results were observed when patients were grouped according to primary and secondary RSA. Increased resistance to uterine blood flow may be an important contributing factor to some causes of RSA and may represent an independent indication of the risk of pregnancy loss.

Recurrent Pregnancy Loss and Inappropriate Local Immune Response to Sex Hormones

The cause of recurrent miscarriage is often unknown. Recurrent miscarriage may be associated with inappropriate responses to progesterone and estrogen. We examined whether the condition may be diagnosed by skin testing. In a longitudinal prospective study, the weal and flare reaction after intradermal injection of estradiol and progesterone was compared in 29 women with recurrent miscarriage to the response in 10 healthy women. Reactions were evaluated after 20 min, 24, and 48 hr and 5 days later. Estrogen hypersensitivity was found in 23 patients, and progesterone hypersensitivity in 20 patients. No patient in the control group demonstrated sex hormone hypersensitivity. Recurrent pregnancy loss may be associated with inappropriate local immune responses to sex hormones. Further research is necessary into the mechanisms of hypersensitivity to estrogen and progesterone and their interactions with other systems.

CAN INFECTION WITH CYTOMEGALOVIRUS, PARVOVIRUS B19 AND HERPES SIMPLEX VIRUS CAUSE RECURRENT PREGNANCY LOSS?

Objective: This study aimed to assess the probability of cylomegalovirus, parvovirus B 19, and herpes simplex 1, 2 virusinfection to cause recurrent miscarriage.Study Design: Prospective study.Settings: Antenatal outpatient clinic of Mansoura University Hospital and Clinical pathology department, faculty ofMedicine, Mansoura University during the period from February 2005 to September 2006Methods: Patients included in the study were collected from those attending (he antenatal outpatient clinic of MansouraUniversity Hospitals and were grouped into 2 groups; those with prior recurrent miscarriage (3 or more), with nouterine malformation that may be a cause of recurrent miscarriage (excluded by hyslerosalpingograms) (11=50). Theother group included 12 women with normal pregnancy used as control. Blood samples were taken from each woman c<:sent to the clinical pathology department for detection Ig M by ELISA & PCR for the genomes,Results: Parvovirus IgM had the highest rate (84%) followed by HSVI. 2 IgM (50%) and CMV IgM (12%) ill therecurrent abortion group. In controls, only parvovirus B19 IgM was positive in 2 cases (16.7%). In PCR study for viralDNA, parvovirus B19 was positive in 24 cases (48%), HSV2 in 16 cases (32%) and CMV was positive in 6 cases(12%) in recurrent abortion group with statistically significant difference between both groups.Conclusion: We can conclude that viral infections might play a role in recurrent abortion especially parvovirus B19 andHSV2.