Improved accuracy of hysteroembryoscopic biopsies for karyotyping early missed abortions.
OBJECTIVE
To assess the potential of direct embryo and chorion biopsies obtained by hysteroembryoscopy for karyotyping early missed abortions.


METHODS
Clinical prospective descriptive study.


METHODS
Instituto Valenciano de Infertilidad, Valencia, Spain.


METHODS
Sixty-eight women (71 gestational sacs) with missed abortions. The gestational age on ultrasound was 6.3 weeks (range, 4-10 weeks).


METHODS
Transcervical hysteroembryoscopy before curettage.


METHODS
Comparison between the cytogenetic results from hysteroembryoscopic biospies and those of the curettage material.


RESULTS
Hysteroembryoscopic biopsies could be taken in 97.2% of the gestational sacs. Direct embryo and chorion biopsies were suitable for chromosomal analysis. Selective samples identified misdiagnoses of the conventional curettage karyotype due to maternal contaminating tissues in 22.2% of the cases. Direct hysteroembryoscopic biopsies also enabled the diagnosis of a true placental mosaicism and the study of the individual karyotype of each gestational sac in bizygotic twin missed abortions.


CONCLUSIONS
In early missed abortions, karyotypes from direct hysteroembryoscopic biopsies were more accurate than those from the curettage material. The finding of a 46,XX karyotype in the curettage material is not a reliable result.
Ferro
Jaime
J
Instituto Valenciano de Infertilidad, Valencia, Spain. ummf@ivi.es
Martínez
Ma Carmen
MC
Lara
Coral
C
Pellicer
Antonio
A
Remohí
José
J
Serra
Vicente
V
D000030:Abortion, Missed / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D000328:Adult; D001706:Biopsy; D002823:Chorion / Q000473:pathology; D003475:Curettage; D020732:Cytogenetic Analysis; D003951:Diagnostic Errors; D004622:Embryo, Mammalian / Q000473:pathology; D005260:Female; D005332:Fetoscopy; D006801:Humans; D015907:Hysteroscopy; D007621:Karyotyping / Q000379:methods*; D008875:Middle Aged; D009030:Mosaicism / Q000473:pathology; D010920:Placenta / Q000473:pathology; D011446:Prospective Studies; D014429:Twins, Dizygotic / Q000235:genetics