Recurrent abortion.

The causes of recurrent reproductive failure are diverse. Many of them are not evident in routine clinical practice and some are still unknown to sophisticated researchers in the field of reproduction. A rational clinical evaluation of the couple will identify the known causes and suggest the unknown causes. More recently the unknown causes have been further classified because of advances in cytogenetic techniques. Abortion material can now be divided into aneuploid and euploid conditions. Heteromorphic banding techniques are useful in exploring both the parental source and the mechanism responsible for recurrent aneuploidy. Delays in ovulation and fertilization may be closely linked to these cytogenetic errors. Identification of euploid abortuses in this unknown group will allow for diagnosis of endocrine, immunologic, and teratologic causes yet to be discovered. With identification of known causes, the treatment is clear cut. All other couples are at the present time dependent upon the availability of techniques to identify unknown causes. Treatment must center on normalization of ovulation, synchronization of sperm deposition and ovulation, and optimization of the maternal environment in which fertilization will occur for these couples of unknown causes.