Objective: To compare the subsequent reproductive outcomes in couples with a history of recurrent pregnancy loss (RPL) associated with and without chromosome abnormalities.Methods: A retrospective cohort and case-control study were conducted.Chromosome karyotype analysis was performed on 2720 couples with RPL using standard GTG-banding, C-banding and NOR-banding.By means of a questionnaire, the clinical features and detailed obstetric history were collected.The reproductive outcomes were recorded through telephone interviews for at least 12 months after chromosome analysis.Some carriers family members were recalled back to be interviewed about reproductive history and performed karyotype analysis.Results: Among the 2720 RPL couples, there were 137 carrier couples with chromosomal abnormalities (5.04%, 137/2720), including 74 cases of structural chromosome rearrangements (2.72%), 55 cases of polymorphisms (2.02%) and others.Of the 339 participant couples, the delivery rate in normal chromosome group was slightly higher than all chromosomal abnormality group (56.7% vs 51.3%, P=0.357); the miscarriage and unpregnancy rate were a little lower (11.9% vs 13.3%, P=0.729; 31.5% vs 35.4%, P=0.464), although the differences were not statistically significant.Different types of chromosome abnormality groups were also followed by similar subsequent reproductive outcomes (P>0.05).Through the pedigree analysis, chromosomal abnormalities of 17 carriers were inherited from one of their parents, another one was de novo and inherited from his mother simultaneously.However, most of their parents did not have the same history of RPL.Conclusion: Couples with RPL associated with parental chromosomal abnormalities do not have significantly lower live birth rate than non-carrier couples.Parental karyotype analysis might not be a good predictor of the subsequent reproductive outcomes.