Frequency of etiological factors and cost effectiveness of the work up for patients with history of recurrent pregnancy loss.

OBJECTIVE: To assess the frequency of the etiological factors during the evaluation of patients with recurrent abortions. The cost effectiveness of the most frequent positive findings will be assessed. STUDY DESIGN: This is a retrospective study in which 97 patient charts were evaluated and only 90 charts were included in this study. The diagnostic studies for every patient including hysterosalpingogram, endometrial biopsy, cervical cultures for Chlamydia and ureaplasma, and chromosomal karyotyping for the couple were assessed. The cost analysis was based on the CPT coding for each test. RESULTS: The frequency of the tests with highest positive findings were hysterosalpingogram, endometrial biopsy, cervical cultures, and immunologic studies. Chromosomal karyotyping has a low positive yield in evaluation of these patients. CONCLUSION: In evaluating patients with recurrent miscarriages, treating physicians should take into consideration the tests which have a high positive yield as a first step. Chromosomal karyotyping should be evaluated in specific situations.