Etiology of Recurrent Pregnancy Loss
<LI class=LM>In 50% or more of cases, the etiology of RPL is not known and couples have a completely normal evaluation.
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<LI class=LM>Genetic/parental chromosomal abnormality. An occult chromosomal abnormality in either the male or female partner is the cause of RPL in 3% to 5% of all cases. These chromosomal abnormalities are termed 鈥渙ccult鈥?because the individuals who carry them have a normal amount of DNA and appear normal (they are often described as abnormal but balanced).
<LI class=LM>However, portions of their chromosomes are rearranged in a way that makes them less capable of producing cytoge-netically normal gametes and predisposes to RPL.
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Antiphospholipid syndrome (APS) is an autoimmune condition characterized by poor obstetric outcomes (recurrent or late pregnancy loss, stillbirth) and thrombophilia in the setting of autoan-tibodies that cause hyper coagulation in vivo. It accounts for approximately 15% of RPL.
Anatomic causes account for 15% of RPL. Congenital abnormalities of the uterus have been strongly associated with early recurrent pregnancy loss and second-trimester loss.
Endocrinologic factors