title: Embryo selection versus natural selection: how do outcomes of comprehensive chromosome screening of blastocysts compare with the analysis of products of conception from early pregnancy loss (dilation and curettage) among an assisted reproductive technology population?
abstract: OBJECTIVE
  To compare the incidence of numerical chromosomal abnormalities (NCAs) reported after preimplantation genetic screening (PGS) analysis compared with that reported after cytogenetic analysis of products of conception after spontaneous abortion.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Private academic in vitro fertilization center.
  
  
  METHODS
  Cytogenetic reports of patients who underwent an IVF cycle with PGS of at least one biopsied embryo were compared with cytogenetic analysis reported from patients who had dilation and curettage (D&C) for the treatment of a spontaneous abortion after assisted reproductive technology (ART) treatment.
  
  
  METHODS
  None.
  
  
  METHODS
  Frequencies for each numerical chromosomal abnormality from both groups were compared.
  
  
  RESULTS
  A total of 1,069 NCAs were reported after PGS (trisomy 54.3%, monosomy 45.7%, no polyploidies), resulting in a trisomy/monosomy ratio of 0.82. A total of 447 NCAs was reported after D&C (trisomy 83%, polyploidy 10.7%, monosomy 6.3%). The aneuploidies most frequently identified were similar in both groups and included 15, 16, 18, 21, and 22. Monosomies (n = 28, 6.3%) were rarely observed in the group that underwent D&C after ART.
  
  
  CONCLUSIONS
  This review provides an analysis of the most commonly identified NCAs after PGS and in first-trimester D&C samples in an infertile population utilizing ART. Although monosomies comprised >50% of all cytogenetic anomalies identified after PGS, there were very few identified in the post-D&C samples. This suggests that although monosomies occur frequently in the IVF population, they commonly do not implant. Despite this difference, this study demonstrated that the specific NCAs observed after PGS analysis and D&C were comparable.
authors.affiliation: Reproductive Medicine Associates of New York, New York, New York. Electronic address: jrodriguez@rmany.com.
authors.forename: Jorge
authors.initials: J
authors.lastname: Rodriguez-Purata
authors.affiliation: Reproductive Medicine Associates of New York, New York, New York.
authors.forename: Joseph
authors.initials: J
authors.lastname: Lee
authors.affiliation: Reproductive Medicine Associates of New York, New York, New York.
authors.forename: Michael
authors.initials: M
authors.lastname: Whitehouse
authors.affiliation: Reproductive Medicine Associates of New York, New York, New York.
authors.forename: Rose Marie
authors.initials: RM
authors.lastname: Moschini
authors.affiliation: Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, New York.
authors.forename: Jaime
authors.initials: J
authors.lastname: Knopman
authors.affiliation: Reproductive Medicine Associates of New York, New York, New York.
authors.forename: Marlena
authors.initials: M
authors.lastname: Duke
authors.affiliation: Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, New York.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Sandler
authors.affiliation: Reproductive Medicine Associates of New York, New York, New York; Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, New York.
authors.forename: Alan
authors.initials: A
authors.lastname: Copperman
mesh_terms: D000022:Abortion, Spontaneous / Q000175:diagnosis / Q000235:genetics* / Q000601:surgery; D000328:Adult; D001755:Blastocyst / Q000473:pathology*; D002869:Chromosome Aberrations; D020732:Cytogenetic Analysis; D004107:Dilatation and Curettage; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D011261:Pregnancy Trimester, First; D019836:Preimplantation Diagnosis; D012189:Retrospective Studies; D012307:Risk Factors; D012641:Selection, Genetic; D016896:Treatment Outcome; D055815:Young Adult
keywords: In vitro fertilization; dilation and curettage; numerical chromosomal abnormalities; preimplantation genetic screening; products of conception