title: Transcervical embryoscopic and cytogenetic findings reveal distinctive differences in primary and secondary recurrent pregnancy loss.
abstract: To assess the cytogenetic and embryoscopic characteristics of primary and secondary recurrent pregnancy loss.
  
  
  
  Clinical prospective descriptive study.
  
  
  
  Tertiary care center.
  
  
  
  Nine hundred and eighty-four women affected by first-trimester pregnancy loss; 145 patients with recurrent pregnancy loss (RPL) and 839 patients with nonrecurrent pregnancy loss as controls.
  
  
  
  Transcervical embryoscopic examination of the embryo before uterine evacuation, and cytogenetic analysis of the chorionic villi by standard G-banding cytogenetic techniques.
  
  
  
  Aneuploidy frequency in the primary and secondary RPL group and the nonrecurrent pregnancy loss (non-RPL) control group.
  
  
  
  Patients with RPL showed statistically significantly fewer aneuploid pregnancy losses (odds ratio [OR] 0.596; 95% confidence interval [CI], 0.40-0.88). Primary RPL was associated with lower aneuploidy rates compared with the non-RPL group (OR 0.423; 95% CI, 0.27-0.66) while secondary RPL was not (OR 1.414; 95% CI, 0.67-2.99). Patients with primary RPL had statistically significantly more morphologically normal embryos compared with non-RPL and secondary RPL.
  
  
  
  Patients' embryos after primary and secondary RPL show distinctive differences in aneuploidy and morphologic defect rates. These findings suggest different treatment approaches for the patients with primary and secondary RPL.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria; Wunschbaby Institut Feichtinger, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Feichtinger
authors.affiliation: Wunschbaby Institut Feichtinger, Vienna, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Wallner
authors.affiliation: Department of Obstetrics and Gynecology, Danube Hospital, Vienna, Austria.
authors.forename: Beda
authors.initials: B
authors.lastname: Hartmann
authors.affiliation: Department of Pathology, Cytogenetic Laboratory, Danube Hospital, Vienna, Austria.
authors.forename: Angelika
authors.initials: A
authors.lastname: Reiner
authors.affiliation: Department of Obstetrics and Gynecology, Danube Hospital, Vienna, Austria. Electronic address: thomas.philipp@wienkav.at.
authors.forename: Thomas
authors.initials: T
authors.lastname: Philipp
mesh_terms: D000026:Abortion, Habitual / Q000175:diagnosis* / Q000209:etiology* / Q000235:genetics / Q000473:pathology; D000328:Adult; D000782:Aneuploidy; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002871:Chromosome Banding; D002877:Chromosomes, Human; D004622:Embryo, Mammalian / Q000473:pathology*; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects; D005332:Fetoscopy; D006801:Humans; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers
keywords: Abnormal embryonic development; chromosome abnormalities; missed abortion; repeated pregnancy loss; transcervical embryoscopy