1. RECURRENT PREGNANCY LOSS

2. 1. Anatomic 2. Infectious 3. Endocrine 4. Immunologic 5. Genetic 6. Male factor 7. Environment al _________

3. Congenital Uterine Septum T-Shaped Uterus - DES ? Cervical Incompetence Acquired Fibroid Synechiae Polyps Deformities/Cervical Incompetence _________

5. Systemic Infections Endometritis Cervicitis Bacterial Vaginosis _________

6. Ovulatory Defects Luteal Phase Defects Thyroid Dysfunction Diabetes/Insulin Resistance _________

8. Balanced Translocations Random Chromosomal Abnormalities Thrombophilias Various Other Genetic Derangements _________

9. Autoimmune Phospholipid Antibodies Lupus Anticoagulant Thyroid Antibodies Other Autoimmune Antibodies Alloimmune Host Response Antibodies Others _________

10. DNA fragmentation Aneuploidy Specific gene abnormalities

11. Chemical Thermal Radiation Traumatic Infectious Other _________

12. Examination Ultrasound Hysterosalpingogram Sonohysterogram Hysteroscopy Other Imagining Modalities _________

14. Cultures – Cervical – Other Blood Tests – Hepatitis A, B, C, ?? – Toxoplasmosis – STS – Rubella – CMV – Chlamydial Antibodies Endometrial Biopsy _________

15. Follicle Development US/Estradiol Luteal Phase Progesterone/Endometrial Biopsy Thyroid TSH (T 3, T 4 ) Thyroid Antibodies (http://www.medscape.com/viewarticle/747914?src= mp&spon=16)http://www.medscape.com/viewarticle/747914?src= mp&spon=16) Other _________

16. aPTT Lupus Anticoagulant Phospholipid Antibody Panel See next slide ± Thyroid Antibodies ±EmbryoToxic Antibodies ± Natural Killer Cells _________

17. 1. Phospholipid isotypes of: -aCA, aPI, aPS, aPE, aPC 2. Lupus anti-coagulant 3. Anti-Beta-2-Glycoprotein 1 antibodies

18. History Tissue Culture (POC) Other Genetic Markers (thrombophilias) See next slide Sperm DNA Fragmentation Assay Karyotyping of Husband and Wife CVS Amniocentesis _________

19. Anti-Thrombin III APTT Factor V Leiden MTHFR PAI-I Protein C Protein S Prothrombin