title: Is karyotyping couples experiencing recurrent miscarriage worth the cost?
abstract: Karyotyping couples that have had recurrent miscarriages detects balanced rearrangements in carrier parents who can be offered prenatal cytogenetic analysis to prevent the birth of a subsequent child with an unbalanced rearrangement. In four UK centres, over periods of 5-30 years, balanced rearrangements were found in 406 out of 20,432 parents that had experienced miscarriage (1.9%), but only four unbalanced rearrangements were found after referral for prenatal diagnosis because of a balanced parental translocation ascertained for recurrent miscarriages. At an estimated cost of 3-4 million pounds, these data raise doubts about the cost effectiveness of current policies on the routine karyotyping of couples experiencing repeated miscarriages.
authors.affiliation: Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury District Hospital, Salisbury, UK. john.barber@soton.ac.uk
authors.forename: J C K
authors.initials: JC
authors.lastname: Barber
authors.forename: A E
authors.initials: AE
authors.lastname: Cockwell
authors.forename: E
authors.initials: E
authors.lastname: Grant
authors.forename: S
authors.initials: S
authors.lastname: Williams
authors.forename: R
authors.initials: R
authors.lastname: Dunn
authors.forename: C M
authors.initials: CM
authors.lastname: Ogilvie
mesh_terms: D000026:Abortion, Habitual / Q000235:genetics* / Q000517:prevention & control; D025063:Chromosome Disorders / Q000175:diagnosis* / Q000235:genetics; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007621:Karyotyping; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000191:economics*; D012189:Retrospective Studies