Department of Obstetrics and Gynecology, Division of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria.
Wunschbaby Institut Feichtinger, Vienna, Austria.
J Assist Reprod Genet. 2018 Aug;35(8):1401-1406. doi: 10.1007/s10815-018-1226-1. Epub 2018 Jun 18.
The aim of the study was to assess cytogenetic and embryoscopic characteristics in subsequent miscarriages of spontaneous pregnancy losses (SPL) and recurrent pregnancy losses (RPL).
A retrospective cohort of 75 women was affected by repeated pregnancy loss. Of those, 34 had SPL, 24 primary RPL, and 17 secondary RPL. Ploidy status and morphology was analyzed by transcervical embryoscopic examination of the embryo and cytogenetic analysis of the chorionic villi in subsequent miscarriages.
Similar rates of recurrent ploidy status were observed between first and second miscarriage in SPL and RPL (82.4% recurrent ploidy status in SPL, p > 0.999; 73% recurrent ploidy status in RPL, p = 0.227). No difference was found regarding recurrent abnormal morphology between SPL and RPL (p = 0.092). However, secondary RPL resulted significantly more often in recurrent abnormal morphology compared to primary RPL (p = 0.004).
High rates of recurrent normal/abnormal karyotypes were observed in all groups with a majority of embryos presenting with recurrent abnormal morphology. Secondary RPL presented significantly more often with recurrent abnormal morphology compared to primary RPL. These findings offer prognostic information for the affected patient and might impact treatment choice.
本研究旨在评估自然妊娠丢失（SPL）和复发性妊娠丢失（RPL）后续流产的细胞遗传学和胚胎镜特征。
回顾性分析了 75 名反复妊娠丢失的女性。其中，34 例为 SPL，24 例为原发性 RPL，17 例为继发性 RPL。通过经宫颈胚胎镜检查胚胎和绒毛膜活检的细胞遗传学分析，分析后续流产的倍性状态和形态。
在 SPL 和 RPL 中，首次和第二次流产的复发性倍性状态相似（SPL 中复发性倍性状态为 82.4%，p>0.999；RPL 中复发性倍性状态为 73%，p=0.227）。SPL 和 RPL 之间，复发性异常形态无差异（p=0.092）。然而，继发性 RPL 复发性异常形态的发生率明显高于原发性 RPL（p=0.004）。
所有组中均观察到复发性正常/异常核型的高发生率，大多数胚胎存在复发性异常形态。与原发性 RPL 相比，继发性 RPL 复发性异常形态的发生率明显更高。这些发现为受影响的患者提供了预后信息，并可能影响治疗选择。
