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Hum. Reprod. Advance Access published online on September 23, 2004
Human Reproduction, doi:10.1093/humrep/deh532
© 2004 by European Society of Human Reproduction and Embryology
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Received June 21, 2004
Accepted August 26, 2004

Article

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

Osama M.H. Habayeb 1 and Justin C. Konje 1*

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

* To whom correspondence should be addressed. E-mail: jck4{at}le.ac.uk.


  Abstract

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.

Keywords: one-stop clinic; recurrent miscarriage.
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