Karyotype of the abortus in recurrent miscarriage.

ABSTRACT

OBJECTIVE: To assess the chromosomal aberrations in the abortus in recurrent miscarriage and the live birth rate after a euploid or aneuploid miscarriage. DESIGN: Retrospective analysis. SETTING: Tertiary referral unit in university hospital. PATIENT(S) One hundred sixty-seven patients with 3 to 16 miscarriages before 20 weeks. INTERVENTION(S) Material collected at curettage from 167 abortuses was analyzed by standard G-banding techniques. MAIN OUTCOME MEASURE(S) The incidence of aberrations and the outcome of the subsequent pregnancy were assessed according to the embryonic karyotype. RESULT(S) In this study 125 specimens were successfully karyotyped. Of these, 29% (36 of 125) had chromosome aberrations; 94% of the aberrations were aneuploidy, and 6% were structural. The most prevalent anomalies were chromosome 16, 18, and 21 trisomies, triploidy, and monosomy X. After an aneuploid miscarriage, there was a 68% subsequent live birth rate (13 of 19) compared to the 41% (16 of 39) rate after a euploid abortion. CONCLUSION(S) The low (29%) incidence of aberrations indicates that alternative mechanisms may be responsible for the majority of recurrent miscarriages. These figures provide a basis for assessing the efficacy of therapy for recurrent miscarriage. If further studies confirm that patients with karyotypically abnormal fetuses have a good prognosis, an informed decision can be made as to whether further investigations and treatment should be undertaken.