Recurrent pregnancy loss (RPL) is a frustrating problem for both the patient and the clinician. The causes of RPL are diverse and may be associated with genetic, anatomic, microbiologic, endocrine, or immunologic factors. When a couple is ready for an evaluation, the nurse practitioner needs to be able to discuss possible causes, aspects of diagnostic testing, and available options. Reassurance and clear information about prognosis are important and emotional support must be offered throughout the investigation and subsequent pregnancy.