Idiopathic Recurrent Miscarriage is Caused Mostly by Aneuploid Embryos
Current preimplantation screening results with array comparative genomic hybridization indicatea significant decrease in the miscarriage rate of idiopathic recurrent pregnancy loss patients. Furthermore, this confirms that idiopathic recurrent miscarriage is mostly caused by chromosomal abnormalities in embryos.
Brooke Hodes-Wertz, M.D., Jamie Grifo, M.D., Ph.D., Shahin Ghadir, M.D., Brian Kaplan, M.D., Carl A. Laskin, M.D., Michael Glassner, M.D., Santiago Munné, Ph.D.
Vol 98, Issue 3, Pages 675-680
To determine any beneficial effects of preimplantation genetic screening (PGS) of all chromosomes by array comparative genomic hybridization (aCGH), either with day 3 or blastocyst biopsy, for idiopathic RPL patients in comparison to their expected loss rate.
Multiple fertility centers
287 cycles of couples with idiopathic RPL (defined as 2 or more losses)
Main Outcome Measures:
Spontaneous abortion rate, euploidy rate
PGS was done using day 3 biopsy (n=193) or blastocyst biopsy (n=94), followed by analysis with aCGH.
2,282 embryos were analyzed, of which 35% were euploid and 60% were aneuploid. There were 181 embryo transfer cycles, of which 100 (55%) became pregnant with an implantation rate of 45% (136 sacs/299 replaced embryos) and 94 cycles (92%) are ongoing (past second trimester) or delivered. The miscarriage rate found was to be only 6.9% (7/102) compared to the expected rate of 33.5% in a RPL control population and 23.7% in an infertile control population.
Current PGS results with aCGH indicate a significant decrease in the miscarriage rate of idiopathic RPL patients and high pregnancy rates. Furthermore, this further suggests that idiopathic recurrent miscarriage is mostly caused by chromosomal abnormalities in embryos.
Read the full text at: http://www.fertstert.org/article/S0015-0282(12)00579-1/fulltext