Idiopathic Recurrent Miscarriage is Caused Mostly by Aneuploid Embryos

Capsule:
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.

Authors:
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.

Volume 98, Issue 3, Pages 675-680, September 2012

Abstract:

Objective:
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.

Design:
Case-series report

Setting:
Multiple fertility centers

Patients:
287 cycles of couples with idiopathic RPL (defined as 2 or more losses)

Main Outcome Measures:
Spontaneous abortion rate, euploidy rate

Methods:
PGS was done using day 3 biopsy (n=193) or blastocyst biopsy (n=94), followed by analysis with aCGH.

Results:
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.

Conclusions:
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.

  • Carmen Rubio

    Encouraging study supporting the relevance of aneuploidy in RM as previosly described by
    FISH publications. We do not have experience in polar body biopsy, but
    currently we are obtaining similar results with day-3 biopsy and aCGH for this
    population, with ongoing implantation rates close to 50%.

  • Mike Hsieh

    Interesting study. This article adds to the growing evidence that PGD might have a role in couples with fail IVF cycles or recurrent pregnancy lost.

    Increased sperm aneuploidy of severe cryptospermic(<5 mil/mL) men has been demonstrated previously. Since most of these patients are undergoing IVF/ICSI, it's not surprising that their embryo also have chromosomal abnormalities.

    Are anybody aware of any study looking at chromosomal abnormalities of eggs of women with recurrent pregnancy lost?

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