Abnormal embryonic development diagnosed embryoscopically in early intrauterine deaths after in vitro fertilization: a preliminary report of 23 cases.
OBJECTIVE
To provide data about the phenotypic appearance of the embryo of early failed pregnancies after IVF.


METHODS
Clinical prospective descriptive study.


METHODS
Tertiary care center.


METHODS
Twenty-three women who had conceived by IVF and had a missed abortion before 12 weeks of gestation.


METHODS
Embryoscopic examination of the embryo before curettage. Cytogenetic analysis of the chorionic villi by standard G-banding cytogenetic techniques or by comparative genomic hybridization in combination with flow cytometry analysis.


METHODS
Embryonic phenotype and karyotype were determined.


RESULTS
Twenty-one of 23 IVF embryos showed structural defects on embryoscopic examination. Seventeen of 23 specimens had a chromosomal abnormality. The majority were numerical aberrations such as monosomy X (2 cases). Trisomies for chromosomes 18 (one case), 16 (three cases), 15 (one case), 14 (two cases), 13 (one case), 12 (one case), 11 (one case), 10 (one case), 9 (one case), 8 (one case), and 3 (one case) were observed. A structural chromosome anomaly leading to a chromosomal trisomy was observed in one case. Aneuploidy explained the grossly abnormal embryonic development documented by embryoscopy in 15 of 21 cases.


CONCLUSIONS
Aneuploidy is the major factor affecting normal embryonic development in missed abortions after IVF. Further investigation is needed to elucidate mechanisms that might prevent normal embryogenesis but evade detection by the cytogenetic techniques used in the present study.
Philipp
Tom
T
Ludwig Boltzmann Institute of Clinical Gynecology and Obstetrics, Danube Hospital, Vienna, Austria. thomas.philipp@wienkav.at
Feichtinger
Wilfried
W
Van Allen
Margot I
MI
Separovic
Evica
E
Reiner
Angelika
A
Kalousek
Dagmar K
DK
D000030:Abortion, Missed / Q000235:genetics; D000328:Adult; D000782:Aneuploidy; D002869:Chromosome Aberrations; D047108:Embryonic Development; D005260:Female; D005313:Fetal Death / Q000175:diagnosis* / Q000196:embryology* / Q000235:genetics / Q000473:pathology; D005332:Fetoscopy; D006801:Humans; D007621:Karyotyping; D010641:Phenotype; D011446:Prospective Studies