Higher chromosomal abnormality rate in blastocysts from young patients with idiopathic recurrent pregnancy loss

Abstract

Objective: To determine whether the incidence of chromosomal abnormalities in blastocysts is higher in patients with idiopathic recurrent pregnancy loss (iRPL) who underwent preimplantation genetic testing for aneuploidy (PGT-A) than in those who underwent preimplantation genetic testing for monogenic defects (PGT-M). Design: Retrospective cohort study. Setting: University-affiliated reproductive center. Patient(s): A total of 62 patients with iRPL underwent 101 PGT-A cycles (iRPL group), and 212 patients underwent 311 PGT-M cycles (control group). Interventions(s): Blastocyst biopsy and comprehensive chromosome screening technologies, including single-nucleotide polymorphism microarrays and next-generation sequencing. Main Outcome Measure(s): Incidence of chromosomal abnormalities in blastocysts and clinical miscarriage (CM) rate.Result(s): Stratification analysis by maternal age showed an increased incidence of chromosomal abnormalities in the iRPL group aged %35 years (48.9% vs. 36.9%), whereas no significant increase was found in the iRPL group aged >35 years (66.9% vs. 61.4%). After transfer of euploid embryos, women aged %35 years with iRPL exhibited an increased CM rate compared with the control group (26.1% vs. 3.1%). Conclusion(s):Young patients with iRPL have a significantly higher rate of chromosomal abnormalities in blastocysts compared with patients with no or sporadic CM. Although euploid embryos were transferred after PGT-A, young patients with iRPL had a higher CM rate, which may indicate that chromosomal abnormalities might not be the only causal factor for iRPL. Therefore, the role of PGT-A in iRPL still needs to be clarified. (Fertil Steril Ò 2020;113:853-64. Ó2019 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

Telomere Length in Idiopathic Recurrent Pregnancy Loss

“…It is an accepted fact that the risk of chromosomal abnormalities is one of the important causes of first trimester pregnancy losses, and increases in parallel with maternal age. Notwithstanding, a recently published study found a higher rate of chromosome anomalies in the blastocyst stage in women with iRPL under 35 years of age [31]. This shows that chronological age may not always indicate biological age.…”

Chromosomal Concordance between the Baby Produced by Preimplantation Genetic Testing Embryo and the Trophectoderm Biopsy: a Retrospective Study

“…First of all, our results manifested that only 58.8% and 76. A number of previous studies adopted TE biopsies as a suitable source for PGT (10,16,17). However, the accuracy of TE biopsy for PGT to determine an euploid embryo is still a controversial issue.…”

Preimplantation Genetic Testing: Where We Are Today

“…The incidence of aneuploidies in blastocysts from patients with idiopathic RPL undergoing PGT-A and PGT for monogenic diseases (PGT-M) resulted to be increased in women aged ≤35 years (48.9% vs. 36.9%), whereas no significant increase was found in group aged >35 years (66.9% vs. 61.4%). However, despite euploid embryo transfer, young patients had a higher miscarriage rate (26.1% vs. 3.1%) suggesting that in these group of patients RPL may derived not only from genetic reasons [92].…”