João Paolo Bilibio1,2,3,4, Thiago Belém Gama1,4, Izabel Cristina Magalhães Nascimento1,4, Arivaldo José Conceição Meireles2,4, Ariene Simona Cohen de Aguiar1,4,5, Fábio Costa do Nascimento2,4, Pânila Longhi Lorenzzoni2,4. 1. Department of Obstetrics and Gynecology, Universidade Federal do Pará, Belém, Pará, Brazil. 2. Clinica de Reprodução Assistida Pronatus, Belém, Pará, Brazil. 3. Post doctoral Program of the Programa de Pós Graduação de Ciências Médicas da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Su, Brazil. 4. Grupo de Pesquisa Bilibio, Universidade Federal do Pará, Belém, Pará, Brazil. 5. Programa de Residência Médica em Ginecologia e Obstetrícia, Hospital Bettina Ferro de Souza, Universidade Federal do Pará, Belém, Pará, Brazil.
Abstract
PROBLEM: We aimed to investigate the main causes of recurrent miscarriage (RM) in patients with losses after spontaneous gestation (SG) and after in vitro fertilization (IVF). METHOD OF STUDY: A prospective case-control study was conducted. The eligible patients were women who had experienced two or more consecutive abortions after <12 weeks' gestation, two consecutive losses after SG, or two consecutive losses after IVF. All patients were subjected to the following evaluations: karyotyping of the aborted material, alloimmune and autoimmune marker testing, and acquired and hereditary thrombophilia marker testing. RESULTS: In total, 58 patients were eligible: 32 patients with RM after SG and 26 patients with RM after IVF. The factors associated with RM were genetic (29%), immune (14%), thrombophilic (21%), and thrombophilic and immune (24%), and only 12% of the cases were idiopathic. Comparing the two study groups (SG and IVF), all studied factors were similar, except for a higher ANA positivity observed in the SG group (SG 30.4% vs IVF 5.3%, OR 8.6 (CI 1.1-21.1, P .048). CONCLUSION: Our study identified the possibly factors associated with recurrent miscarriage in 86% of the cases, and these factors appear to be similar in patients with recurrent miscarriage after spontaneous gestation and IVF. This study demonstrates that IVF with PGT-A with euploid embryo transfer could reduce abortions by up to 29%, but other factors need to be investigated even in patients undergoing in vitro fertilization.
PROBLEM: We aimed to investigate the main causes of recurrent miscarriage (RM) in patients with losses after spontaneous gestation (SG) and after in vitro fertilization (IVF). METHOD OF STUDY: A prospective case-control study was conducted. The eligible patients were women who had experienced two or more consecutive abortions after <12 weeks' gestation, two consecutive losses after SG, or two consecutive losses after IVF. All patients were subjected to the following evaluations: karyotyping of the aborted material, alloimmune and autoimmune marker testing, and acquired and hereditary thrombophilia marker testing. RESULTS: In total, 58 patients were eligible: 32 patients with RM after SG and 26 patients with RM after IVF. The factors associated with RM were genetic (29%), immune (14%), thrombophilic (21%), and thrombophilic and immune (24%), and only 12% of the cases were idiopathic. Comparing the two study groups (SG and IVF), all studied factors were similar, except for a higher ANA positivity observed in the SG group (SG 30.4% vs IVF 5.3%, OR 8.6 (CI 1.1-21.1, P .048). CONCLUSION: Our study identified the possibly factors associated with recurrent miscarriage in 86% of the cases, and these factors appear to be similar in patients with recurrent miscarriage after spontaneous gestation and IVF. This study demonstrates that IVF with PGT-A with euploid embryo transfer could reduce abortions by up to 29%, but other factors need to be investigated even in patients undergoing in vitro fertilization.
Authors: Lilja Hardardottir; Maria Victoria Bazzano; Laura Glau; Luca Gattinoni; Angela Köninger; Eva Tolosa; Maria Emilia Solano Journal: Front Immunol Date: 2021-11-16 Impact factor: 7.561