Higher chromosomal abnormality rate in blastocysts from young patients with idiopathic recurrent pregnancy loss

Idiopathic recurrent pregnancy loss is associated with a higher incidence of chromosomal abnormalities in blastocysts.

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Volume 113, Issue 4, Pages 853–864

Authors:

Xin-Yan Liu, Ph.D., Qi Fan, M.D., Jing Wang, M.D., Rong Li, M.D., Yan Xu, Ph.D., Jing Guo, Ph.D., Yi-Zi Wang, Ph.D., Yan-Hong Zeng, M.D., Chen-Hui Ding, Ph.D., Bing Cai, Ph.D., Can-Quan Zhou, Ph.D., Yan-Wen Xu, Ph.D.

Abstract:

Objective

To determine whether the incidence of chromosomal abnormalities in blastocysts is higher in patients with idiopathic recurrent pregnancy loss (iRPL) who underwent preimplantation genetic testing for aneuploidy (PGT-A) than in those who underwent preimplantation genetic testing for monogenic defects (PGT-M).

Design

Retrospective cohort study.

Setting

University-affiliated reproductive center.

Patient(s)

A total of 62 patients with iRPL underwent 101 PGT-A cycles (iRPL group), and 212 patients underwent 311 PGT-M cycles (control group).

Interventions(s)

Blastocyst biopsy and comprehensive chromosome screening technologies, including single-nucleotide polymorphism microarrays and next-generation sequencing.

Main Outcome Measure(s)

Incidence of chromosomal abnormalities in blastocysts and clinical miscarriage (CM) rate.

Result(s)

Stratification analysis by maternal age showed an increased incidence of chromosomal abnormalities in the iRPL group aged ≤35 years (48.9% vs. 36.9%), whereas no significant increase was found in the iRPL group aged >35 years (66.9% vs. 61.4%). After transfer of euploid embryos, women aged ≤35 years with iRPL exhibited an increased CM rate compared with the control group (26.1% vs. 3.1%).

Conclusion(s)

Young patients with iRPL have a significantly higher rate of chromosomal abnormalities in blastocysts compared with patients with no or sporadic CM. Although euploid embryos were transferred after PGT-A, young patients with iRPL had a higher CM rate, which may indicate that chromosomal abnormalities might not be the only causal factor for iRPL. Therefore, the role of PGT-A in iRPL still needs to be clarified.



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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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Go to the profile of Ahmet Turp
Ahmet Turp 7 months ago

This is a nice article however when i looked at the Table 1 basal FSH does not differ between patients under 35 age between groups iRPL and control(ovarian reserve test of paitents under 35). So with younger age with iRPL patients male factor can be an important issue. A Statistical analyses of semen quality between iRPL and control in patients under 35 years.