RPL is a challenging clinical problem for both patients and clinicians. Well-accepted causes include uterine malformation, antiphospholipid syndrome, and parental chromosomal abnormalities; however, the majority of RPL cases are idiopathic (up to 75%). Furthermore, the majority of the prevalent management strategies are either contentious or unproven. It is reassuring that idiopathic RPL has a modestly favorable prognosis.