In vitro fertilization plus preimplantation genetic diagnosis in patients with recurrent miscarriage: an analysis of chromosome abnormalities in human preimplantation embryos.
OBJECTIVE
To analyze the incidence of numeric chromosomal abnormalities in preimplantation embryos from women with unexplained recurrent miscarriage (RM) so as to seek an etiology and to determine whether the use of IVF may be indicated to treat these cases.


METHODS
Prospective controlled study.


METHODS
University laboratory of reproductive genetics and a tertiary referral center for infertility.


METHODS
Nine women with a mean (+/-SD) of 3.9 +/- 0.6 RMs who were undergoing IVF and preimplantation genetic diagnosis, and a control group of young (n = 10) and older (n = 6) patients who were undergoing preimplantation genetic diagnosis because of sex-linked diseases.


METHODS
In vitro fertilization, embryo culture for 72 hours, blastomere biopsy, and analysis of chromosomes 13, 16, 18, 21, 22, X, and Y with the use of fluorescent in situ hybridization. Transfer of chromosomally normal embryos into the uterus.


METHODS
Numeric chromosomal abnormalities in human embryos.


RESULTS
Sixty-six embryos from patients with RM were compared with 62 embryos from young patients and 41 embryos from older patients. There was a significant increase in the rate of abnormal embryos in the patients with RM and the older patients compared with the controls. Abnormalities in most of the chromosomes studied were higher in the RM group than in the control group, especially those affecting chromosome 13.


CONCLUSIONS
There was an increase in numeric chromosomal abnormalities in preimplantation embryos from women with RM that could be the cause of infertility in many couples with unexplained RM. The use of IVF in such circumstances may be indicated if successful preimplantation genetic diagnosis is added to the procedure.
Pellicer
A
A
Instituto Valenciano de Infertilidad, Valencia, Spain. apellicer@interbook.net
Rubio
C
C
Vidal
F
F
Mínguez
Y
Y
Giménez
C
C
Egozcue
J
J
Remohí
J
J
Simón
C
C
D000026:Abortion, Habitual / Q000235:genetics*; D000328:Adult; D001706:Biopsy; D001757:Blastomeres; D002869:Chromosome Aberrations; D002882:Chromosomes, Human, Pair 13; D046508:Culture Techniques; D004622:Embryo, Mammalian / Q000502:physiology; D047108:Embryonic Development; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011446:Prospective Studies