Repeated first-trimester pregnancy loss: evaluation and management

The clinical management of repetitive first-trimester pregnancy loss is handicapped by inadequate answers to four fundamental questions. These questions center around understanding the true scope of the problem, differentiating between euploidic and aneuploidic loss, identifying the parental source of the gametogenic error, and clarifying the role of molecular developmental mutants in euploidic abortion. In spite of these limitations a diagnostic and therapeutic program is outlined for couples with repetitive early abortion. Informational gaps are identified and the future role of molecular biology in clarifying some of these issues is optimistically outlined.