TNF-α is one of the cytokines produced by the immune system. Many studies have been done to investigate the role of the immune system in first trimester pregnancy loss. Objective: To evaluate the association of TNF-α with recurrent and missed miscarriage. Method: a case-control study involved 35 women, 15 with recurrent miscarriage (at least three consecutive spontaneous abortions) , 10 with missed miscarriage and 10 with normal first trimester pregnancy (control group). The study was conducted

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... from the 1st of January to 30th of June 2008. Blood samples were taken from these women, TNF-α was measured in the sera by an immunoenzymometric assay using Biosource TNF-α EASIA kit (Biosource Europe S.A.). Results: student t-test was applied to analyze the difference in serum TNF-α level between the groups. The level of significance was defined at P value < 0.05. Significantly higher levels of TNF-α was found in women with recurrent miscarriage as compared to control group (68.94 pg/ ml versus 27.40 pg/ml). The difference was also significant when comparing women with missed miscarriage with the control group (54.39 pg/ml versus 27.40 pg/ml). The level of TNF-α was higher in women with recurrent miscarriage compared to women with missed miscarriage, however the difference between them was not statistically significant. Conclusion: TNF-α has a significant association with miscarriage, the level is significantly higher in patients with recurrent and missed miscarriage compared to normal pregnant women; the level is higher in those with recurrent miscarriage when compared to patients with missed miscarriage.