Abstract

International guidelines on recurrent miscarriage (RM) or infertility do not advise on how couples experiencing RM with infertility should receive care. In this study, we used key performance indicators, which had been developed from international guidelines on RM, to examine the care received by women with RM and infertility who attended the Pregnancy Loss Clinic over a 13-year period. We examined clinic letters and other health records to see if standards of care were met. In 128 women with RM and infertility, we found that care was mostly in line with guidelines. However, we noted that women were not always fully informed of risk factors such as weight or smoking or the chances of pregnancy when RM was unexplained. We also found that women didn’t always receive investigations like ultrasound, particularly 3D ultrasound, or genetic investigations of pregnancy tissue. Most women received aspirin, with smaller numbers being prescribed a blood thinner or steroids. Surgery was not required by most women. 70% of women had another pregnancy, and 36% of these used some form of fertility treatment to conceive. The livebirth rate in women who conceived was 63% with 35% having a further first-trimester miscarriage and 2% having a second-trimester miscarriage.