[Use of a diagnostic prospective algorithm for patients with recurrent miscarriage]. / Aplicación de un algoritmo diagnóstico prospectivo para pacientes con pérdida fetal recurrente.

The application of a diagnostic algorithm to couples with recurrent pregnancy loss, was evaluated in this descriptive, prospective, clinical trial, at Infertility Clinic and Assisted Reproduction Unit, Instituto Nacional de Perinatología (INPer), México City. Fifty couples with primary or secondary recurrent pregnancy loss, were studied. A study protocol was applied to evaluate the following factors of miscarriage: anatomic, endocrine, infectious, genetic and immunologic. The frequency of altered factors was determined in the couples including in this trial. There were no cases of diabetes mellitus or impaired glucose tolerance in the studied group. The most common abnormal findings were: luteal phase defects; genital infections (Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum) and; an elevated frequency of chromosomal abnormalities. In addition, in 16% of the couples there was not an identified cause of their problem. The applied algorithm find the etiology of the recurrent pregnancy loss in the 84% of the couples studies. The method included new technologies (detection of anti-immunity, allo-immunity and infectious diseases), however, need corrections to increase its diagnostic and prognosis accuracy.