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The perinatologists are emerging as the physicians who evaluate and treat women with recurrent pregnancy loss. Recurrent miscarriage, previously referred to as habitual abortion, affects almost 1% of couples. The etiologies of recurrent miscarriage are diverse and may be divided into genetic defects, such as chromosomal anomalies; maternal reproductive anatomic disease, both developmental and acquired, such as septate uterus or cervical incompetence; and systemic maternal disease such as antiphospholipid antibody syndrome or maternal diabetes. A cause for recurrent miscarriage can be identified approximately 60% of the time. We emphasize the tremendous psychological impact of recurrent miscarriage. We contrast any proposed treatments with the empiric fact that with no treatment after recurrent losses, couples still have a 60 to 70% chance of delivering a viable infant.