to exclude the possibility of balanced chromosomal translocations. Ultrasounds may be used to oversee the morphological growth and development of follicles throughout IVF treatment, in addition to assessing endometrial thickness. Hysteroscopy is an essential part of investigating a couple’s RIF pathology and is used as a diagnostic tool to examine the cervical canal and uterine cavity. Management In depth reviews of the underlying causes of a couple's infertility should be undertaken with a qualified fertility specialist in order to make decisions regarding further management. Modifiable risk factors include smoking, alcohol consumption and BMI. Women with RIF should be advised to abstain from both alcohol and smoking, and male partners may also consider cessation of smoking due to effects associated with weaker sperm counts and damage to sperm DNA and motility. An ideal BMI target for women with RIF is between 19 and 29; obese women may consider structured weight-loss programmes and regular exercise over bariatric surgery due to potential folate, iron, vitamin B12 and other nutritional deficiencies. Table below showing the main first-line treatments for couples undergoing RIF. References Women's health Reproduction