Introduction RECURRENT Spontaneous ABORTION (RSA) is one of the most common complications in reproductive ages. Several factors such as genetic, anatomical, and endocrine disorders, infection, and environmental and immunological factors have been involved in RSA. In cases of ABORTIONs, whose reasons are known, the chance of success in pregnancy can be increased after the elimination of the defective factors; but, in women with a history RSA with an unknown reason, there is an imbalance in the regulatory mechanisms of immune cells, and even the pattern of immunological cells changes in these women. Actually, an inappropriate immune response is often associated with pregnancy loss. Immunologic factors involved in patients with RSA have gradually been identified, using diagnostic methods and several studies. The present study was conducted with the aim of reviewing RSA immunology and new findings in this field. In this study, more than 40 articles on immunologic factors involved in RSA were reviewed. Conclusion Based on the current findings related to the immunology of pregnancy, due to the extensive role of the immunologic factors in this disorder, more accurate identification of the functional role of each immunologic factor becomes more important. Also, new therapeutic approaches will be addressed to the researchers in this field based on the changes in the function of immune system.

Background: A vast variety of factors may cause RECURRENT pregnancy loss. Blood group incompatibility of parents could cause ABORTION. The examination of couples or twins, blood groups showed that the blood group incompatibility can affect adversely the outcome of pregnancy. Couples with blood group incompatibility are more involved in spontaneous miscarriage. Antigenes in two different blood groups could disorganize implantation. Aborted embryos with normal karyotype showed more frequently blood group incompatibility with their mother. Abnormal newborn and stillbirth were observed more frequent in couples with incompatible blood groups than without. Methods: This study investigates relationship between blood groups incompatibility and RECURRENT miscarriage in couples who were referred to genetic counseling clinic of Yazd Research & Clinical Center for Infertility. The blood group of 100 couples with RECURRENT miscarriage was evaluated using slide test method. Their ABORTIONs were unknown after possible evaluation. One hundred and twelve fertile couples entered to this study as control group, which have at least two normal children without any ABORTION. Results: The results showed blood group incompatibility was more frequent in couples with RECURRENT ABORTION than fertile couples. Conclusion: Blood group incompatibility of parents could causes antigen-antibody interaction between mother and fetus, which ended with ABORTION. In previous study it was believed that blood group incompatibility cases fetal anemia and stillbirth.

objective: To Determine the incidence of diminished ovarian reserve in unexplained RECURRENT ABORTION. Materials and methods: among 116 women with complaint of RECURRENT ABORTION who referred to Ghaem hospital, after evaluation, 25 women with unexplained RECURRENT ABORTION were chosen as the test group and the control group (n=25) were women with a history of normal pregnancy. Mean age, day 3 serum FSH and E2 levels, presence or absence of a history of infertility and menstrual cycle lengths were compared between two groups. Results: Day 3 FSH and E2 Levels were higher in the unexplained RECURRENT ABORTION group compared with the control group (61% VS 16%) P<0.005. Other factors did not differ between two groups. Conclusion: Women with unexplained RECURRENT ABORTION have a greater incidence of elevated day 3 serum FSH and E2 levels than do women with a normal pregnancy history. Therefore diminished ovarian reserve may contribute to RECURRENT pregnancy loss and should be considered as a part of the work – up for unexplained RECURRENT ABORTION.  

Most maternal cardiac disease in Western societies is now congenital in origin. This relates to the significant improvements in congenital cardiac surgery during the last years. Some patients will present for the first time in pregnancy with symptoms and learn that they have congenital heart disease. So all patients should have a detailed evaluation and appropriate counseling before pregnancy. Ebstein anomaly is a rare and complex congenital heart disorder occurring in 1 per 200 000 live births and, first described by a German physician Wilhelm Ebstein in 1866 in a report titled, "Concerning a very rare case of insufficiency of the tricuspid valve caused by a congenital malformation. This anomaly accounts for 0.5%-0.7% of cases of congenital heart disease. The average life duration of patients with Ebstein’s anomaly is 25-30 years. The malformation consists of apical displacement of the tricuspid valve with resultant regurgitation and enlargement of the right heart chambers, resulting in arrhythmias and heart failure. The common cardiac anomalies associated with the condition are atrial septal defect (ASD) in 90% of patients, anatomic or functional tricuspid atresia in 30%, Wolff-Parkinson-White (WPW) syndrome in 15% and less commonly ventricular septal defect (VSD), pulmonic stenosis or atresia and mitral valve prolapse. Survival into adulthood is common and patients present with cyanosis, dyspnea and palpitations.

Background: RECURRENT ABORTION is a difficult medical problem happening in about 1-2% of fertile women. Most spontaneous miscarriages which happen in the first and second trimesters are caused by chromosomal abnormalities. Objective: The present study tries to find the rate of chromosomal abnormalities in couples with RECURRENT pregnancy loss. Materials and Methods: In total 165 couples were referred to genetic counseling clinic with a history of at least three previous ABORTIONs. In all women antibodies against toxsoplasmose, rubella and cytomegalovirus (CMV) were analysed by ELIZA. In 88 couples karyotyping was conducted by analysis of G and/or C banding. Metaphase spreads were made from  phytohaemaglutinin-stimulated peripheral lymphocytes using standard cytogenetic techniques. The chromosomal status was analyzed using CytoVision Ultra ver.4.0 from Applied Imaging. The x2-test and ANOVA were used for statistical evaluation. The level of p<0.05 was considered as significance. Results: Most of the patients had 3 repeated ABORTIONs (61.2%). Cytogenetic analysis performed for 88 couples and karyotypes of 12.5% of them were abnormal. The majority of them had monosomy X (6.82%), followed by balanced translocation (2.27%). The number of female carries chromosomal abnormality exceeded significantly than of male. Coefficient of inbreeding in more than 50% of couples had fifth degree of relationship (89 out of 165). Conclusion: Our results showed that 12.5% of the couples with missed ABORTION had an abnormal karyotype, with no other abnormality. Cytogenetic findings in spontaneous aborted specimens could provide valuable information for genetic counseling and prenatal care in future pregnancies in couples with a history of repeated pregnancy loss.  

Background: Approximately 2-4% of all women have RECURRENT spontaneous ABORTION (RSA); however, the cause is determined in only 50% of cases. Recent studies have shown an association between thyroid autoantibodies as a sign of thyroid autoimmunity and ABORTION. The aim of the present study was to determine whether circulating anti-thyroid peroxidase (anti-TPO) was associated with RSA.Materials and Methods: In this observational analytic study, Sera from 58 non-pregnant women with a history of RSA and also 58 healthy, fertile subjects with at least one live birth as control (Aging from 18 to 45 years) were tested for thyroid peroxidase antibodies by means of a standard Anti-TPO ELISA kit. We used data collection forms and SPSS software for data analysis.Results: Of 116 women, 8 (13.8%) of the control subjects and 12 (20.7%) of the women with a history of RSA had positive results for anti-TPO. There was not any significant association between presence of anti-TPO and RSA.Conclusions: We did not find any correlation between the presence of TPO antibodies and ABORTION in women with a history of RSA. On the basis of this study, testing for anti-TPO doesn’t seem to be useful in the evaluation of patients with a history of RSA.

Introduction: RECURRENT spontaneous ABORTION is defined as the occurrence of more than two clinical miscarriages in one woman. Several factors, including endocrine irregularities, genetics and environmental factors, are involved in this kind of infertility. The aim of this study was to survey the association of HOXA10 (rs267601473) polymorphism with the risk of RECURRENT spontaneous ABORTION in our population. Methods: In the present case-control study, the HOXA10 (rs267601473) polymorphism was investigated in 70 infertile woman and 100 healthy participants using PCR-RFLP methods. Then, the data were analyzed by SPSS software version 18 and also were compared using Chi-square test and Logistic regression model. The p-value was found to be statistically significant (p<0. 05). Results: Our results showed significant association between the HOXA10 (rs267601473) polymorphism and RECURRENT spontaneous ABORTION (OR=0. 143, 95% CI=0. 056-0. 368; p<0. 0001). Our findings showed that T allele frequency in women with RECURRENT spontaneous ABORTION had significant difference compared to the control group (OR=0. 2, 95% CI=0. 11-0. 4; p<0. 0001). Conclusion: The results of this study reveal that the HOXA10 (rs267601473) polymorphism is significantly associated with RECURRENT spontaneous ABORTION in our population.

Introduction: Toxoplasmosis, a parasitic infection, varies in its prevalence in various countries. Some studies have suggested its role in the ABORTION. The aim of this study was to determine the role of anti-Toxoplasma antibody as an etiologic factor in RECURRENT pregnancy failure. Materials and Methods: A case-control study was carried out on 120 women who unexplained RECURRENT pregnancy loss (group I) with 50 women had matched with normal reproductive outcome allocated as control group. Sera from 120 cases and 50 controls were tested for anti-Toxoplasma IgG antibody by ELISA.Results: The present study revealed a higher percentage of anti-Toxoplasma IgG antibodies positivity in women with repeated ABORTIONs (17.5%) than control group (14%), although the difference between them was not statistically significant (p=0.7).Conclusion: The analysis of these results shows that in spite of proved role of Toxoplasma gondii in fetal ABORTION, it is still controversial; whatever toxoplasmosis can cause repeated ABORTION. Thus a study to associate toxoplasmosis with RECURRENT ABORTIONs is difficult because a large cohort of women with toxoplasmosis would be needed to assess the incidence of otherwise unexplained RECURRENT ABORTIONs in them compared with controls.