Vol 92, No 7 (2021)
Research paper
Published online: 2021-03-29

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Cytogenetic analysis of early pregnancy loss after assisted reproduction treatment using intracytoplasmic sperm injection

Aret Kamar1, Nurettin Turktekin1, Ramazan Ozyurt1, Cemil Karakus2, Devrim Saribal3, F. Sinem Hocaoglu-Emre4
Pubmed: 33844246
Ginekol Pol 2021;92(7):475-480.

Abstract

Objectives: To evaluate the incidence of numerical chromosomal abnormalities in the patients with early pregnancy loss (EPL) following in vitro fertilization, and evaluate the role of different confounders of the risk of chromosomal abnormality-related pregnancy loss.
Material and methods: A retrospective chart review of all patients from our in vitro fertilization (IVF) center who conceived using assisted reproduction techniques between April 2017 and 2019, who experienced a subsequent early pregnancy loss, and whose abortus materials were successfully karyotyped were included.
Results: Of the 243 patients experienced an early loss, the overall rate of chromosomal abnormality was 46.75%. The overall rate of aneuploidy in our patient group was 88.8% (64/72), whereas 6.94% (5/72) of the abnormal karyotypes were polyploid. The most common type of trisomy was Trisomy 16 (20.0%; 11/55) followed by Trisomy 15 (14.5%; 8/55). Univariate and multivariate analyses showed that maternal age (< 35 years) and the total number of retrieved oocytes per cycle (≥ 5) were risk factors for a chromosomal abnormality (< 0.001; < 0.05, respectively). The adjusted OR of karyotypic abnormalities was 0.45 for the antagonist cycle type (p < 0.05), and 0.58 for frozen embryo transfer (p < 0.05).
Conclusions: Karyotypic abnormality is one of the main reasons for pregnancy loss following an IVF procedure. Although the pregnancy rates increased as a result of novel technologies, the ratio of EPL is still high. The implementation of preimplantation genetic screening techniques might lower the incidence of EPL due to chromosomal abnormalities, thus decreasing the burden on the physicians and the patients.

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References

  1. Spontaneous Abortion. 1992.
  2. Balen AH, MacDougall J, Tan SL. The influence of the number of embryos transferred in 1060 in-vitro fertilization pregnancies on miscarriage rates and pregnancy outcome. Hum Reprod. 1993; 8(8): 1324–1328.
  3. Westergaard HB, Johansen AM, Erb K, et al. Danish National IVF Registry 1994 and 1995. Treatment, pregnancy outcome and complications during pregnancy. Acta Obstet Gynecol Scand. 2000; 79(5): 384–389.
  4. Iews M, Tan J, Taskin O, et al. Does preimplantation genetic diagnosis improve reproductive outcome in couples with recurrent pregnancy loss owing to structural chromosomal rearrangement? A systematic review. Reprod Biomed Online. 2018; 36(6): 677–685.
  5. Ubaldi FM, Capalbo A, Colamaria S, et al. Reduction of multiple pregnancies in the advanced maternal age population after implementation of an elective single embryo transfer policy coupled with enhanced embryo selection: pre- and post-intervention study. Hum Reprod. 2015; 30(9): 2097–2106.
  6. Martínez MC, Méndez C, Ferro J, et al. Cytogenetic analysis of early nonviable pregnancies after assisted reproduction treatment. Fertil Steril. 2010; 93(1): 289–292.
  7. Ou Z, Yin M, Chen Z, et al. Meta-analysis of the association between chromosomal polymorphisms and outcomes of embryo transfer following in vitro fertilization and/or intracytoplasmic sperm injection. Int J Gynaecol Obstet. 2019; 144(2): 135–142.
  8. Rodriguez-Purata J, Lee J, Whitehouse M, et al. 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? Fertil Steril. 2015; 104(6): 1460–14666.e1.
  9. Nayak S, Pavone ME, Milad M, et al. Aneuploidy rates in failed pregnancies following assisted reproductive technology. J Womens Health (Larchmt). 2011; 20(8): 1239–1243.
  10. Revelli A, Biasoni V, Gennarelli G, et al. IVF results in patients with very low serum AMH are significantly affected by chronological age. J Assist Reprod Genet. 2016; 33(5): 603–609.
  11. Alanazi H, Bushaqer N, Ayyoub H, et al. Antimullerian hormone (AMH) level and IVF/ICSI cycle outcome in expected poor responders. Middle East Fertility Society Journal. 2018; 23(3): 246–250.
  12. Jiang X, Yan J, Sheng Y, et al. Low anti-Müllerian hormone concentration is associated with increased risk of embryonic aneuploidy in women of advanced age. Reprod Biomed Online. 2018; 37(2): 178–183.
  13. Zhang J, Liu H, Mao X, et al. Effect of endometrial thickness on birthweight in frozen embryo transfer cycles: an analysis including 6181 singleton newborns. Hum Reprod. 2019; 34(9): 1707–1715.
  14. Wei D, Liu JY, Sun Y, et al. Frozen versus fresh single blastocyst transfer in ovulatory women: a multicentre, randomised controlled trial. Lancet. 2019; 393(10178): 1310–1318.
  15. Wu T, Yin B, Zhu Y, et al. Molecular cytogenetic analysis of early spontaneous abortions conceived from varying assisted reproductive technology procedures. Mol Cytogenet. 2016; 9: 79.
  16. Lanasa MC, Hogge WA, Kubik CJ, et al. A novel X chromosome-linked genetic cause of recurrent spontaneous abortion. Am J Obstet Gynecol. 2001; 185(3): 563–568.
  17. Cheng HH, Ou CY, Tsai CC, et al. Chromosome distribution of early miscarriages with present or absent embryos: female predominance. J Assist Reprod Genet. 2014; 31(8): 1059–1064.
  18. Rodgers CS, Creasy MR, Fitchett M, et al. Solid tissue culture for cytogenetic analysis: a collaborative survey for the Association of Clinical Cytogeneticists. J Clin Pathol. 1996; 49(8): 638–641.
  19. Bell K, Deerlin PV, Haddad B, et al. Cytogenetic diagnosis of “normal 46,XX” karyotypes in spontaneous abortions frequently may be misleading. Fertility and Sterility. 1999; 71(2): 334–341.
  20. Bingol B, Abike F, Gedikbasi A, et al. Comparison of chromosomal abnormality rates in ICSI for non-male factor and spontaneous conception. J Assist Reprod Genet. 2012; 29(1): 25–30.
  21. Zhang T, Sun Y, Chen Z, et al. Traditional and molecular chromosomal abnormality analysis of products of conception in spontaneous and recurrent miscarriage. BJOG. 2018; 125(4): 414–420.
  22. Hu Y, Chen X, Chen LL, et al. Comparative genomic hybridization analysis of spontaneous abortion. Int J Gynaecol Obstet. 2006; 92(1): 52–57.
  23. Robbins SM, Thimm MA, Valle D, et al. Genetic diagnosis in first or second trimester pregnancy loss using exome sequencing: a systematic review of human essential genes. J Assist Reprod Genet. 2019; 36(8): 1539–1548.
  24. Chang J, Boulet SL, Jeng G, et al. Outcomes of in vitro fertilization with preimplantation genetic diagnosis: an analysis of the United States Assisted Reproductive Technology Surveillance Data, 2011-2012. Fertil Steril. 2016; 105(2): 394–400.
  25. Rodriguez-Purata J, Lee J, Whitehouse M, et al. 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? Fertil Steril. 2015; 104(6): 1460–14666.e1.