A young couple has come to the infertility clinic for evaluation. There is history of 3 previous first trimester abortions, the first one at 10 weeks, the second at 8 weeks and the third at 9 weeks. All tests are performed as per the protocol.

1.  Which of the following statements is false?

(a) The man needs to have a sperm count and morphology analysis as poor sperm morphology can lead to recurrent pregnancy loss

(b) Mother needs a HLA phenotype assay as certain HLA types can lead to recurrent pregnancy loss.

(c) Paternal smoking has a strong effect and needs to be avoided

(d) Listeria infection of the endometrium can lead to recurrent pregnancy loss.

Answer: The answer is (d). It has been observed that recurrent pregnancy loss is not caused by any kind of infections of the endmetrium. Certain HLA types in the mother are associated with recurrent pregnancy loss. Poor sperm morphology can also be a cause. Paternal smoking has been shown to cause recurrent pregnancy loss by altering the morphology of the sperm.

2.  The most common reason for first trimester abortion (miscarriage) is:

(e) Chromosomal abnormality in the fetus

(f) Cervical incompetence

(g) Uterine anomalies

(h) Anti Phospholipid Antibody Syndrome

Answer: The answer is (a). The most common cause of early pregnancy loss is chromosomal aberrations in the fetus. Cervical incompetence causes second trimester pregnancy losses. Uterine anomalies can cause pregnancy loss in first trimester but are less common. APLA causes pregnancy loss in first trimester but is not as common as chromosomal abnormality.