BackgroundLeptin is an important hormone during implantation processes and plays a pivotal role in regulating the development of placenta and endo-metrial receptivity. miRNAs are associated with endometrial diseases, preeclampsia, neural tube defects and infertility, providing their potential role in the function of normal reproductive system. The aim of this study was to investigate the role of miRNA-27a and leptin polymorphisms in the development of idiopathic recurrent pregnancy loss (RPL) among Egyptian women. MethodsThis is a case-control study involving 99 women with at least two consecutive recurrent pregnancy losses and 100 females as a control group. The rs7799039 G/A variant in leptin gene (LEP) and miR-27a rs895819 were genotyped by polymerase chain reaction-restriction fragment length polymorphism assay. Odds ratios and 95% confidence intervals were estimated using multivariate analyses. The relationships between the genotypes of each of the two polymorphism genotypes and incidence of RPL as well as other parameters (body mass index, consanguinity, no of abortion and timing of abortion of the RPL patients) were analyzed using multiple linear regression analyses. ResultsStatistical analysis showed that rs7799039 G/A was associated with an increased risk of RPL GA + AA (0.006;0.379 (0.190–0.758) (GG vs. GA: OR ≤0.001; 5.35(2.364–12.109); GG vs. GA + AA(0.006;0.379 (0.190–0.758); GG vs AA 0.124;8.224 (3.19–21.205). There was a strong association of the of A allele with RPL (A vs G < 0.001; 0.416 (0.278–0.621). In rs895819A/G (AA vs. GA: 0.05; 0.492 (0.242–1) there was an associated increased risk of RPL after adjustment for multiple tests using the FDR correction, the P value was significant 0.003. AA vs. GA + GG 0.002; 0.411 (0.232–0.729); AA vs GG <0.001; 0.214 (0.095–0.484). There was a strong association of the of G allele with RPL G vs. A < 0.001; 0.425 (0.281–0.643). ConclusionOur results showed that the rs7799039 G/A in LEP and miR-27a polymorphisms are associated with an increased susceptibility to RPL in the Egyptian Women.