Spontaneous miscarriage is a condition in which the embryo or fetus is spontaneously expelled from the mother before the 28th week of pregnancy for some reason (also called embryonic arrest), and its incidence is about 15-20%. The incidence of spontaneous abortion is about 1% in couples who wish to conceive, and it is called recurrent early spontaneous abortion (ERSA) when it occurs three or more times in a row and within the third trimester. Current research suggests that chromosomal abnormalities in the couple and the hypercoagulable state of the woman’s blood (mostly due to antiphospholipid antibody syndrome) are the main causes of ERSA. Etiology and management 1. Genetic causes About 3-5% of ERSA couples have chromosomal abnormalities, while the incidence of chromosomal abnormalities in the general population is only 0.2%; on the other hand, the couple does not have chromosomal abnormalities, but the embryo has a chromosomal combination error during development. The older the couple, the higher the incidence of chromosomal abnormalities in the embryo. There is no effective treatment for patients with chromosomal abnormalities resulting in ERSA, and the incidence of chromosomally abnormal fetuses can only be estimated through genetic counseling. If the incidence is high, pre-implantation genetic diagnosis or screening (PGD/PGS), sperm donor or egg donor IVF can be used to eliminate or avoid abnormal embryos; or try to conceive first and then do prenatal chromosome examination of the fetus, and once a fatal or teratogenic chromosome abnormality is found, the pregnancy can be terminated. 2, blood hypercoagulability is divided into two categories: hereditary and acquired. Acquired (acquired) is common in our patients, such as thrombophilia due to antiphospholipid antibody syndrome, and special immunosuppressive and anticoagulant treatment can be used for such patients. 3, uterine causes such as patients with larger uterine fibroids, uterine malformations or uterine adhesions are also prone to ERSA. Such patients can be clearly diagnosed by ultrasound, hysterosalpingography, hysteroscopy, MRI, etc. and can be effectively treated by means of surgical plastic surgery. 4, endocrine causes ERSA patients are more common causes of follicular dysplasia, luteal insufficiency, hyperprolactinemia and other endocrine factors, in addition to abnormalities in the function of the thyroid and adrenal glands are also prone to ERSA. Endocrine treatment for ERSA caused by luteal insufficiency is most effective after ovulation promotion and luteal support, and the success rate of pregnancy again after treatment can reach more than 90%. 5, immune factors some patients with ERSA are related to autoantibody production, that is, they may suffer from autoimmune diseases (mostly antiphospholipid antibody syndrome), called autoimmune recurrent spontaneous abortion. The main basis for this is that autoantibodies can be detected in this group of patients, with antiphospholipid antibodies being the most common; others are anti-nuclear antibodies. In addition, some patients may be associated with hyporeactivity to fetal paternal antigens, which is called autoimmune recurrent spontaneous abortion, and these patients lack closed antibodies.