Michael Feichtinger1, Elisabeth Wallner2, Beda Hartmann3, Angelika Reiner4, Thomas Philipp5. 1. Department of Obstetrics and Gynecology, Division of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria; Wunschbaby Institut Feichtinger, Vienna, Austria. 2. Wunschbaby Institut Feichtinger, Vienna, Austria. 3. Department of Obstetrics and Gynecology, Danube Hospital, Vienna, Austria. 4. Department of Pathology, Cytogenetic Laboratory, Danube Hospital, Vienna, Austria. 5. Department of Obstetrics and Gynecology, Danube Hospital, Vienna, Austria. Electronic address: thomas.philipp@wienkav.at.
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.
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.
Authors: T V Nikitina; E A Sazhenova; D I Zhigalina; E N Tolmacheva; N N Sukhanova; I N Lebedev Journal: J Assist Reprod Genet Date: 2020-02-03 Impact factor: 3.412
Authors: Andrea Weghofer; David H Barad; Sarah K Darmon; Vitaly A Kushnir; David F Albertini; Norbert Gleicher Journal: Arch Gynecol Obstet Date: 2020-02-27 Impact factor: 2.344