RSA, defined as 2 or more consecutive pregnancy losses, affects about 2-3% of women achieving pregnancy. The experience takes a heavy emotional, physical and financial toll on patients and their families. Currently accepted testing for uterine anatomic abnormalities, Antiphospholipid antibodies (APA) and karyotypic abnormalities of the parents leave about 50% of RSA unexplained. The lack of clear causality and treatment to prevent repeat episodes adds to the burden of this diagnosis. Testing for thyroid function is considered appropriate for RSA evaluation. Documentation exists that women with euthyroid states have a lower rate of miscarriage than those with overt or subclinical hypothyroidism. Thyroid autoimmunity and miscarriage risk has a pooled odds ratio of 2.55. The purpose of this report is to illustrate a basis for considering a diagnosis of TAARSA along with treatment and rationale for this approach.