International Journal of Gynecology and Obstetrics 83 (2003) 179–186 0020-7292/03/$30.00  2003 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. doi:10.1016/S0020-7292(03)00209-1 Article Recurrent pregnancy loss due to familial and non-familial habitual molar pregnancy T.K. Al-Hussaini *, D.M. Abd El Aal , I.B. Van den Veyver a, a b,c Department of Obstetrics and Gynecology, Assiut University Hospital, Assiut University, Assiut, Egypt a Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA b Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA c Received 29 January 2003; received in revised form 17 April 2003; accepted 1 May 2003 Abstract Objectives: To present a series of women with recurrent molar pregnancies, including rare familial cases, and discuss etiology and treatment options. Methods: We performed a detailed clinical evaluation and pedigree analysis of five Egyptian women with recurrent pregnancy loss due to molar pregnancy. Results: The women had a history of four to nine consecutive hydatidiform moles but of no viable pregnancies. Two of the women had molar pregnancies with different husbands who themselves had viable offspring from previous wives; and three of them, who belonged to a family with extensive intermarriage, had a pedigree consistent with an autosomal recessive maternal-effect mutation. Conclusions: Recurrent pregnancy loss due to habitual molar pregnancy is uncommon and familial cases are extremely rare. The etiology of this disorder is not well understood but likely results from a maternal-effect mutation. Management options are limited, especially for couples who desire to have their own genetic offspring.  2003 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. Keywords: Assisted conception; Gestational trophoblastic disease; Habitual hydatidiform (vesicular) mole; Recurrent; Maternal- effect mutation 1. Introduction Complete hydatidiform mole (CHM) is an abnormal pregnancy with excessive proliferation of placental villi, but in which embryonic devel- opment is severely stunted or absent. Its incidence *Corresponding author. Tel.: q20-88-337899; fax: q20-88- 333327. E-mail address: tarekalhussaini@yahoo.com (T.K. Al-Hussaini). in developed countries is estimated between 1y 1000 and 1y1500, but it is more prevalent in South East Asia. However, habitual (or recurrent) molar pregnancy is much rarer w1x. The etiology of molar pregnancies is still incompletely understood. Molar pregnancies can be interspersed with normal pregnancies or not w2x. In this article, we report on a series of five Egyptian women who had four, seven, seven, eight, and nine molar pregnancies, respectively, without an intervening normal pregnancy.