OBJECTIVE: To assess the potential of direct embryo and chorion biopsies obtained by hysteroembryoscopy for karyotyping early missed abortions. DESIGN: Clinical prospective descriptive study. SETTING: Instituto Valenciano de Infertilidad, Valencia, Spain. PATIENT(S): Sixty-eight women (71 gestational sacs) with missed abortions. The gestational age on ultrasound was 6.3 weeks (range, 4-10 weeks). INTERVENTION(S): Transcervical hysteroembryoscopy before curettage. MAIN OUTCOME MEASURE(S): Comparison between the cytogenetic results from hysteroembryoscopic biospies and those of the curettage material. RESULT(S): Hysteroembryoscopic biopsies could be taken in 97.2% of the gestational sacs. Direct embryo and chorion biopsies were suitable for chromosomal analysis. Selective samples identified misdiagnoses of the conventional curettage karyotype due to maternal contaminating tissues in 22.2% of the cases. Direct hysteroembryoscopic biopsies also enabled the diagnosis of a true placental mosaicism and the study of the individual karyotype of each gestational sac in bizygotic twin missed abortions. CONCLUSION(S): In early missed abortions, karyotypes from direct hysteroembryoscopic biopsies were more accurate than those from the curettage material. The finding of a 46,XX karyotype in the curettage material is not a reliable result.
OBJECTIVE: To assess the potential of direct embryo and chorion biopsies obtained by hysteroembryoscopy for karyotyping early missed abortions. DESIGN: Clinical prospective descriptive study. SETTING: Instituto Valenciano de Infertilidad, Valencia, Spain. PATIENT(S): Sixty-eight women (71 gestational sacs) with missed abortions. The gestational age on ultrasound was 6.3 weeks (range, 4-10 weeks). INTERVENTION(S): Transcervical hysteroembryoscopy before curettage. MAIN OUTCOME MEASURE(S): Comparison between the cytogenetic results from hysteroembryoscopic biospies and those of the curettage material. RESULT(S): Hysteroembryoscopic biopsies could be taken in 97.2% of the gestational sacs. Direct embryo and chorion biopsies were suitable for chromosomal analysis. Selective samples identified misdiagnoses of the conventional curettage karyotype due to maternal contaminating tissues in 22.2% of the cases. Direct hysteroembryoscopic biopsies also enabled the diagnosis of a true placental mosaicism and the study of the individual karyotype of each gestational sac in bizygotic twin missed abortions. CONCLUSION(S): In early missed abortions, karyotypes from direct hysteroembryoscopic biopsies were more accurate than those from the curettage material. The finding of a 46,XX karyotype in the curettage material is not a reliable result.
Authors: Marta N Shahbazi; Tianren Wang; Xin Tao; Bailey A T Weatherbee; Li Sun; Yiping Zhan; Laura Keller; Gary D Smith; Antonio Pellicer; Richard T Scott; Emre Seli; Magdalena Zernicka-Goetz Journal: Nat Commun Date: 2020-08-10 Impact factor: 14.919