title: Single-Nucleotide Polymorphism-Microarray Ploidy Analysis of Paraffin-Embedded Products of Conception in Recurrent Pregnancy Loss Evaluations.
abstract: OBJECTIVE
  To compare the analysis of chromosome number from paraffin-embedded products of conception using single-nucleotide polymorphism (SNP) microarray with the recommended screening for the evaluation of couples presenting with recurrent pregnancy loss who do not have previous fetal cytogenetic data.
  
  
  METHODS
  We performed a retrospective cohort study including all women who presented for a new evaluation of recurrent pregnancy loss over a 2-year period (January 1, 2012, to December 31, 2013). All participants had at least two documented first-trimester losses and both the recommended screening tests and SNP microarray performed on at least one paraffin-embedded products of conception sample. Single-nucleotide polymorphism microarray identifies all 24 chromosomes (22 autosomes, X, and Y).
  
  
  RESULTS
  Forty-two women with a total of 178 losses were included in the study. Paraffin-embedded products of conception from 62 losses were sent for SNP microarray. Single-nucleotide polymorphism microarray successfully diagnosed fetal chromosome number in 71% (44/62) of samples, of which 43% (19/44) were euploid and 57% (25/44) were noneuploid. Seven of 42 (17%) participants had abnormalities on recurrent pregnancy loss screening. The per-person detection rate for a cause of pregnancy loss was significantly higher in the SNP microarray (0.50; 95% confidence interval [CI] 0.36-0.64) compared with recurrent pregnancy loss evaluation (0.17; 95% CI 0.08-0.31) (P=.002). Participants with one or more euploid loss identified on paraffin-embedded products of conception were significantly more likely to have an abnormality on recurrent pregnancy loss screening than those with only noneuploid results (P=.028). The significance remained when controlling for age, number of losses, number of samples, and total pregnancies.
  
  
  CONCLUSIONS
  These results suggest that SNP microarray testing of paraffin-embedded products of conception is a valuable tool for the evaluation of recurrent pregnancy loss in patients without prior fetal cytogenetic results. Recommended recurrent pregnancy loss screening was unnecessary in almost half the patients in our study.
  
  
  METHODS
  II.
authors.affiliation: Division of Reproductive Endocrinology & Infertility, University of Connecticut Health Center, Farmington, Connecticut.
authors.forename: Bat-Sheva L
authors.initials: BS
authors.lastname: Maslow
authors.forename: Tara
authors.initials: T
authors.lastname: Budinetz
authors.forename: Carolina
authors.initials: C
authors.lastname: Sueldo
authors.forename: Erica
authors.initials: E
authors.lastname: Anspach
authors.forename: Lawrence
authors.initials: L
authors.lastname: Engmann
authors.forename: Claudio
authors.initials: C
authors.lastname: Benadiva
authors.forename: John C
authors.initials: JC
authors.lastname: Nulsen
mesh_terms: D000026:Abortion, Habitual / Q000235:genetics*; D000328:Adult; D000782:Aneuploidy; D015331:Cohort Studies; D005260:Female; D005333:Fetus; D005819:Genetic Markers; D006801:Humans; D020411:Oligonucleotide Array Sequence Analysis; D016612:Paraffin Embedding; D020641:Polymorphism, Single Nucleotide; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies
chemical_list: D005819:Genetic Markers