Chromosomal abnormalities in embryos from couples with a previous aneuploid miscarriage
Fertil Steril. Jul.
2012 doi: 10.1016/j.fertnstert.2012.03.035
OBJECTIVE: To compare the incidence of chromosomal abnormalities in preimplantation embryos from couples undergoing preimplantation genetic screening (PGS) after previous aneuploid miscarriage after either natural conception (NC) or assisted reproductive technology (ART) versus fertile couples who underwent PGS for sex-linked diseases as a control group. DESIGN: Retrospective study. SETTING: IVF clinic. PATIENT(S): Patients with previous aneuploid conception undergoing PGS. INTERVENTION(S): Embryo biopsy, fluorescence in situ hybridization. MAIN OUTCOME MEASURE(S): Embryo aneuploidy rates and pregnancy and implantation rates in couples with a previous aneuploidy for autosomes or sex chromosomes. RESULT(S): The overall rates of chromosomal abnormalities in groups with previous autosomal aneuploidy were significantly higher compared with the control group (67.8% for those whose previous aneuploidy arose after NC and 65.8% for those previously arising after ART, vs. 34.0%). No significant differences were observed in those with previous sex chromosome abnormalities compared with control subjects. Within couples with previous aneuploidies after NC, no difference existed in the incidence of chromosomal abnormalities compared with the ART groups. Clinical outcomes were better (trend) in patients with previous autosomal aneuploidy after NC. CONCLUSION(S): In preimplantation embryos, the incidence of chromosomal abnormalities due to a previous aneuploid miscarriage after either NC or ART is significantly higher than in the control group. Furthermore, this incidence is higher when the previous aneuploidy was for autosomes; PGS is recommended in these couples.