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Hum. Reprod. Advance Access originally published online on September 23, 2004
Human Reproduction 2004 19(12):2952-2958; doi:10.1093/humrep/deh532
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Human Reproduction vol. 19 no. 12 © European Society of Human Reproduction and Embryology 2004; all rights reserved

The one-stop recurrent miscarriage clinic: an evaluation of its effectiveness and outcome

Osama M.H. Habayeb and Justin C. Konje1

Reproductive Sciences Section, Department of Cancer Studies and Molecular Medicine, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, UK

1 To whom correspondence should be addressed. Email: jck4{at}le.ac.uk

BACKGROUND: Couples with recurrent miscarriages make several visits to specialized clinics for investigations before treatment is offered. Consequently, ‘the interval’ between receipt of referral and advice to try for a pregnancy is often lengthy. The objectives of this study were to examine the effect of a ‘one-stop’ clinic on ‘the interval’, throughput and the outcome from this clinic. METHODS: The processes for investigation, management and outcomes of 189 couples seen in our Recurrent Miscarriage Clinic (RMC) and their records were reviewed. RESULTS: The one-stop clinic reduced the interval and number of visits by 36% (206.6 to 130.4 days, P<0.001) and by 60% (2.5 to 1, P<0.002) respectively. The prevalence and frequency of aetiological factors were similar in those with two and three or more miscarriages (41% versus 45%, P>0.05). The commonest aetiological factors were thrombophilias (14%) and antiphospholipid syndrome (11%). No cause was identified in 54% of cases. The pregnancy and live birth rates were best in the idiopathic group (75%), those with thrombophilias (64%) and autoimmune antibodies (83%). Older couples had the worse pregnancy rates and outcome. CONCLUSION: A one-stop clinic significantly shortens ‘the interval’ between referral and initiation of treatment. Investigations should be initiated in women after two consecutive miscarriages.

Key words: one-stop clinic/recurrent miscarriage


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F. Nawroth and D. Foth
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