Human Reproduction, Vol. 18, No. 1, 182-188,
January 2003
© 2003 European Society of Human Reproduction and Embryology
Chromosomal abnormalities and embryo development in recurrent miscarriage couples
1 Instituto Valenciano de Infertilidad (IVI), Plaza Policia Local, 3, 46015 Valencia, 2 Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Blasco Ibáñez, 17, 46010 Valencia, 3 Unitat de Biología Cellular, Facultat de Ciències, Universitat Autònoma of Barcelona, 08193 Bellaterra, Barcelona, Spain 4 To whom correspondence should be addressed at: Instituto Valenciano de Infertilidad, Guardia Civil 23, 46020 Valencia, Spain. e-mail: apellicer{at}interbook.net
BACKGROUND: Chromosomal abnormalities are an important cause of spontaneous abortion and recurrent miscarriage (RM). Therefore, we have analysed the incidence of chromosomal abnormalities and embryo development in patients with RM. METHODS: Preimplantation genetic diagnosis (PGD) was performed on 71 couples with RM and 28 couples undergoing PGD for sex-linked diseases (control group). Chromosomes 13, 16, 18, 21, 22, X and Y were analysed by fluorescence in-situ hybridization. RESULTS: The implantation rate in RM patients was 28% and three patients (13%) miscarried. The percentage of abnormal embryos was significantly increased (P < 0.0001) in RM patients compared with controls (70.7 versus 45.1%). All of the embryos were abnormal in 19 cycles (22.1%) and repeated PGD cycles yielded similar rates of chromosomal abnormalities in 14 couples. Anomalies for chromosomes 16 and 22 were significantly higher (P < 0.01) in RM cases. In the RM population, euploid embryos reached the blastocyst stage more frequently than abnormal embryos (61.7 versus 24.9%; P < 0.0001). CONCLUSIONS: RM is associated with a higher incidence of chromosomally abnormal embryos, of which some are able to develop to the blastocyst stage. IVF plus PGD is an important step in the management of these couples, but the technique has to move towards a full chromosome analysis.
Key words: aneuploidy/blastocyst/FISH/PGD/recurrent miscarriage
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