IntroductionUp to 30% of human embryos fail to survive (1). Embryonic aneuploidy is the main cause of spontaneous abortion in approximately 65% of cases (2,3). High rates of numerical chromosome abnormalities or aneuploidies may also be associated in conceptions after assisted reproductive therapy (ART) (4,5). Although the rate of occurrence increases with maternal age, semen quality and the morphological quality of the embryos could also be associated with aneuploidy (6). The exogenous follicle stimulating hormone (FSH) is often administered to induce multiple follicle growth in ART. Evidence has suggested that elevated levels of endogen (≥20 ng/ml) and exogenous gonadotropins might cause chromosomal abnormalities (7,8). It was hypothesized that "hormonal imbalance causes an increased risk of non-disjunction by affecting oocyte ripeness, the rate of meiosis and spindle integrity" (8,9). Another explanation could be the recruitment of poor quality oocytes when the process of the natural selection of a dominant follicle is overridden by ovarian hyperstimulation. Indeed, the cause of miscarriages in the first trimester of the pregnancy is closely related to aneuploidy.Animal and human studies demonstrated in that sudden elevation of FSH damages chromosomes and affects embryo quality (10-14), but no studies have shown a direct link between gonadotropins and the genesis of aneuploidy. To test the hypothesis that exogenous gonadotropins might be related to aneuploidy, we aimed to determine the rate of chromosomal abnormalities in the products of first trimester miscarriages in patients who were pregnant after FSH ovarian stimulation and those of miscarriages of naturally conceived pregnancies.
Materials and MethodsThis was a retrospective cohort study conducted over nine years. The subjects included 985 patients whose abortion materials were karyotyped. Nine hundred and nine of these materials were obtained from naturally conceived pregnancies and 76 were obtained from infertile patients who were pregnant under FSH hyperstimulation in invitro fertilization (IVF). Miscarriage was defined as loss of clinical pregnancy after identification of gestational sac on transvaginal ultrasound. Chorionic villi were carefully dissected from the remaining tissue during the termination procedure,
AbstractObjective: The aim of this study was to determine the rate of chromosomal abnormalities in the products of first trimester miscarriages in patients who were under FSH ovarian stimulation and to compare the results with the products of miscarriages of naturally conceived pregnancies. Materials and Methods: This retrospective cohort study was conducted over a nine-year period. Included were 909 patients who conceived naturally and 76 infertility patients who were under FSH stimulation with first trimester miscarriages karyotyped. The rate of aneuploidy was compared between the two groups. The main outcome measure was the incidence of aneuploidy. Results: In 76 FSH-induced pregnancies, 12 (15.7%) had an abnormal karyotype. The rate of...