Idiopathic recurrent miscarriage is caused mostly by aneuploid embryos.
OBJECTIVE
To determine any beneficial effects of preimplantation genetic screening (PGS) of all chromosomes by array comparative genomic hybridization (aCGH), with either day 3 or blastocyst biopsy, for idiopathic recurrent pregnancy loss (RPL) patients compared with their expected loss rate.


METHODS
Case series report.


METHODS
Multiple fertility centers.


METHODS
A total of 287 cycles of couples with idiopathic RPL (defined as two or more losses).


METHODS
PGS was done with day 3 biopsy (n = 193) or blastocyst biopsy (n = 94), followed by analysis with aCGH.


METHODS
Spontaneous abortion rate, euploidy rate.


RESULTS
A total of 2,282 embryos were analyzed, of which 35% were euploid and 60% were aneuploid. There were 181 embryo transfer cycles, of which 100 (55%) became pregnant with an implantation rate of 45% (136 sacs/299 replaced embryos) and 94 pregnancies (92%) were ongoing (past second trimester) or delivered. The miscarriage rate was found to be only 6.9% (7/102), compared with the expected rate of 33.5% in an RPL control population and 23.7% in an infertile control population.


CONCLUSIONS
Current PGS results with aCGH indicate a significant decrease in the miscarriage rate of idiopathic RPL patients and high pregnancy rates. Furthermore, this suggests that idiopathic recurrent miscarriage is mostly caused by chromosomal abnormalities in embryos.
NYU Fertility Center, New York, New York, USA.
Brooke
B
Hodes-Wertz
Jamie
J
Grifo
Shahin
S
Ghadir
Brian
B
Kaplan
Carl A
CA
Laskin
Michael
M
Glassner
Santiago
S
Munné
D000026:Abortion, Habitual / Q000209:etiology*; D000328:Adult; D000782:Aneuploidy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D019836:Preimplantation Diagnosis