Transcervical embryoscopic and cytogenetic findings reveal distinctive differences in primary and secondary recurrent pregnancy loss

Patients with secondary recurrent pregnancy loss (RPL) show significantly higher aneuploidy rates and morphologic defects compared with primary RPL patients so different treatment approaches should be applied.

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Volume 107, Issue 1, Pages 144-149

Authors:

Michael Feichtinger, M.D., Elisabeth Wallner, M.Sc., Beda Hartmann, M.D., Angelika Reiner, M.D., Thomas Philipp, M.D.

Abstract:

Objective

To assess the cytogenetic and embryoscopic characteristics of primary and secondary recurrent pregnancy loss.

Design

Clinical prospective descriptive study.

Setting

Tertiary care center.

Patient(s)

Nine hundred and eighty-four women affected by first-trimester pregnancy loss; 145 patients with recurrent pregnancy loss (RPL) and 839 patients with nonrecurrent pregnancy loss as controls.

Intervention(s)

Transcervical embryoscopic examination of the embryo before uterine evacuation, and cytogenetic analysis of the chorionic villi by standard G-banding cytogenetic techniques.

Main Outcome Measure(s)

Aneuploidy frequency in the primary and secondary RPL group and the nonrecurrent pregnancy loss (non-RPL) control group.

Result(s)

Patients with RPL showed statistically significantly fewer aneuploid pregnancy losses (odds ratio [OR] 0.596; 95% confidence interval [CI], 0.40–0.88). Primary RPL was associated with lower aneuploidy rates compared with the non-RPL group (OR 0.423; 95% CI, 0.27–0.66) while secondary RPL was not (OR 1.414; 95% CI, 0.67–2.99). Patients with primary RPL had statistically significantly more morphologically normal embryos compared with non-RPL and secondary RPL.

Conclusion(s)

Patients’ embryos after primary and secondary RPL show distinctive differences in aneuploidy and morphologic defect rates. These findings suggest different treatment approaches for the patients with primary and secondary RPL.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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