To test the hypothesis that medical evacuation of the products of conception (POC) in nonviable first trimester pregnancy by the use of methotrexate and misoprostol is effective, safe, cost-effective, and acceptable to patients. We intend to perform a randomized trial to compare the medical management of failed pregnancy to surgical removal by dilation and curettage (D&C). NCRR Clarification: research is on abnormal pregnancy/miscarriage