Association between different morphological types and abnormal karyotypes in early pregnancy loss

Abstract

Objectives To identify the abnormal transvaginal ultrasound (TVS) findings typical of aneuploidic pregnancies that end with early pregnancy loss (EPL). Methods

Correlation analysis between ultrasound findings and abnormal karyotypes in the embryos from early pregnancy loss after in vitro fertilization-embryo transfer

“…We found that this condition was correlated with the highest risk of chromosomal abnormalities, which is consistent with the results of a study by Angiolucci et al [18] (Table 3). However, the rate of chromosomal abnormalities in the early symmetrical arrested growth group in our study was much lower than that reported in this previous study (57.7 vs. 100 %).…”

“…Previous studies have shown different results for the correlation between a small embryonic pole and abnormal karyotypes [17,18] (Table 3). In this study, the abnormality rate in the small embryonic pole group was similar to that of the other groups, including the group with normal ultrasound findings, which is inconsistent with the results of Angiolucci et al [18].…”

“…Goldstein et al and Coulam et al reported that ultrasound findings should not be used to predict the karyotypes associated with spontaneous miscarriages [16,17]. However, recent studies have demonstrated correlations between ultrasound findings and chromosomal anomalies [18,19]. Therefore, the objective of this study was to investigate the correlation between ultrasound findings and abnormal karyotypes associated with EPL after in vitro fertilization-embryo transfer (IVF-ET) based on the largest sample from a single reproductive center to date.…”

“…Six different categories of ultrasound findings were identified from repeated TVS scans of 2172 embryos associated with EPL after IVF-ET: (1) normal ultrasound, 440 cases; the measurements of the gestational sac, yolk sac and embryonic pole were consistent with the GA of the embryo (all were between the fifth and 95th percentile for the expected size) [25]; (2) empty sac, 491 cases with an absence of fetal structures inside the gestational sac [18]; (3) yolk sac only, 454 cases; only a yolk sac was present in the gestational sac, and no embryonic pole or cardiac activity were present [4]; (4) small gestational sac, 86 cases; the diameter of the gestational sac was <5th percentile for its expected size, but the embryonic pole length >5th percentile for its expected size [25]; (5) small embryonic pole, 311 cases; the diameter of the gestational sac was consistent with or larger than predicted based on GA (≥5th percentile for the expected size), but the embryonic pole length was shorter than expected (<5th percentile for the expected size) [25]; and (6) early symmetrical arrested growth, 390 cases; simultaneous growth arrest of the gestational sac and the embryonic pole occurred (both <5th percentile for their expected size) [25].…”

“…Empty gestational sacs have been studied previously, and the results describing their correlation with abnormal karyotypes are inconsistent [5,[16][17][18] (Table 3). Many previous studies are prone to correlate empty gestational sacs with a high prevalence of abnormal karyotypes [16][17][18]. However, Hsin-Hsin et al [29] and Romero et al [5] found a relatively low prevalence of genetic abnormalities associated with pre-embryonic losses.…”