Endocrinopathies associated with recurrent pregnancy loss

Repeated pregnancy wastage is defined as the loss of three consecutive pregnancies at less than 20 weeks of gestation and fetal weight less than 500 g. This article provides guidelines to evaluate endocrinopathies associated with recurrent abortions. Thyroid disorder, although usually obvious, has a high frequency in the female population and should be evaluated and treated, if revealed. Recent studies indicate that thyroid antibodies, even in the absence of abnormal thyroid function tests, may be related to pregnancy loss. Diabetes mellitus should be controlled. Luteal phase defects should be sought and, when consistently documented, treated with clomiphene citrate or progesterone supplementation. Bromocriptine may be added to the treatment of a patient with hyperprolactinemia prior to testing for luteal phase defect. An understanding of the stress and anxiety in these couples should always be considered and included in the treatment style of the physician.