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Recurrent Fetal Aneuploidy and Recurrent Miscarriage

From the Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Salt Lake City, Utah.

Address reprint requests to: Amy Sullivan, md, Department of Obstetrics and Gynecology, University of Utah Health Sciences Center, Room 2B200, 50 North Medical Drive, Salt Lake City, Utah 84132; e-mail: amy.sullivan{at}hsc.utah.edu.

OBJECTIVE: Some investigators have found a high frequency of abortus aneuploidy in women with recurrent miscarriage, suggesting the possibility of recurrent aneuploidy as a cause of recurrent miscarriage. Others contend that aneuploidy is not a cause of recurrent miscarriage. The purpose of this study was to investigate the relationship between fetal aneuploidy and recurrent miscarriage by estimating whether fetal aneuploidy is more common in patients with recurrent miscarriage than in patients with sporadic miscarriage

METHODS: Recurrent miscarriage cases (n = 135) included women who had a subsequent miscarriage in which an abortus karyotype was obtained. Controls (n = 150) were patients experiencing a sporadic miscarriage who had fetal karyotypes performed as part of a study to assess the utility of abortus tissue for transplantation. Karyotype analysis was performed using standard G-banding techniques.

RESULTS: Abortuses from 122 cases and 133 controls were successfully karyotyped. Thirty-one (25.4%) abortuses from cases and 56 (42.1%) from controls were aneuploid (odds ratio 0.47, 95% confidence interval 0.27–0.80). Aneuploid abortuses occurred in 20% of cases and 25% of controls, aged 20–29 years, 19% of cases and 24% of controls, aged 30–34 years, 35% of cases and 47% of controls, aged 35–39 years, and 50% of both cases and controls, aged 40 years or older (not significant). Of 30 cases in whom 2 or more miscarriages were karyotyped, 3 (10%) had aneuploidy in each abortus.

CONCLUSION: In our population of recurrent miscarriage patients, abortus aneuploidy occurred significantly less often than in sporadic miscarriages. The rate of aneuploidy in this study was considerably lower than reported in other studies. If recurrent aneuploidy contributes to recurrent miscarriage, it does so in only a small number of patients.

LEVEL OF EVIDENCE: II-2

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