title: The relationship of recurrent spontaneous miscarriage with reproductive failure.
abstract: OBJECTIVE
  To investigate the reproductive performance of non-pregnant women with recurrent spontaneous miscarriage (RSM) and the association between RSM and polycystic ovary syndrome (PCOS) in reproductive failure.
  
  
  METHODS
  Fifty non-pregnant women with 3 or more consecutive RSM attending our RSM clinic were evaluated prospectively. Detailed history and physical examination were completed. Extensive laboratory investigations, ultrasonographic, radiological and specialized procedures/tests were performed. Those patients who did not achieve pregnancy within the first 6 months of follow-up had appropriate treatment options implemented. The outcome of any subsequent pregnancies was analyzed.
  
  
  RESULTS
  The mean age of the patients was 33.8 +/- 4.6 years (range 22-43 years). The aetiological factors associated with RSM were chromosome anomaly, uterine abnormality, antiphospholipid syndrome, PCOS and infections; 40% were 'unexplained'. Thirty patients (60%) were able to achieve viable pregnancies which progressed to term, resulting in live births. Fourteen of the other 20 patients had high body mass index (BMI) >30 and evidence of PCOS. Of these 20 patients, 13 eventually achieved pregnancies which ended again in first-second-trimester abortions (cause undetermined). The remaining 7 patients (4 with high BMI) who had a combination of male factor/protracted PCOS/ovarian failure did not achieve pregnancies.
  
  
  CONCLUSIONS
  The association of RSM with PCOS resulted in poor reproductive performance, which may progress to reproductive failure.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Kuwait University, Kuwait. michael@hsc.kuniv.edu.kw
authors.forename: Michael
authors.initials: M
authors.lastname: Diejomaoh
authors.forename: Jiri
authors.initials: J
authors.lastname: Jirous
authors.forename: Magda
authors.initials: M
authors.lastname: Al-Azemi
authors.forename: Saba
authors.initials: S
authors.lastname: Baig
authors.forename: Madhu
authors.initials: M
authors.lastname: Gupta
authors.forename: Alaa
authors.initials: A
authors.lastname: Tallat
mesh_terms: D000026:Abortion, Habitual / Q000209:etiology*; D000328:Adult; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors