Risk of Chromosomal Abnormalities in Early Spontaneous Abortion after Assisted Reproductive Technology: A Meta-Analysis

Abstract

BackgroundStudies on the risk of chromosomal abnormalities in early spontaneous abortion after assisted reproductive technology (ART) are relatively controversial and insufficient. Thus, to obtain a more precise evaluation of the risk of embryonic chromosomal abnormalities in first-trimester miscarriage after ART, we performed a meta-analysis of all available case–control studies relating to the cytogenetic analysis of chromosomal abnormalities in first-trimester miscarriage after ART.MethodsLiterature search in the electronic databases MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) based on the established strategy. Meta-regression, subgroup analysis, and Galbraith plots were conducted to explore the sources of heterogeneity.ResultsA total of 15 studies with 1,896 cases and 1,186 controls relevant to the risk of chromosomal abnormalities in first- trimester miscarriage after ART, and 8 studies with 601 cases and 602 controls evaluating frequency of chromosome anomaly for maternal age≥35 versus <35 were eligible for the meta-analysis. No statistical difference was found in risk of chromosomally abnormal miscarriage compared to natural conception and the different types of ART utilized, whereas the risk of fetal aneuploidy significantly increased with maternal age≥35 (OR 2.88, 95% CI: 1.74–4.77).ConclusionsART treatment does not present an increased risk for chromosomal abnormalities occurring in a first trimester miscarriage, but incidence of fetal aneuploidy could increase significantly with advancing maternal age.

A Higher Ovarian Response after Stimulation for IVF Is Related to a Higher Number of Euploid Embryos

“…Yet in humans, studies are scarce and less conclusive. In this context when comparing natural and stimulated cycles, no differences have been observed in terms of cleavage capacity [3], oocyte [4], and embryo aneuploidy rate [5], or incidence of aneuploidy in either aborted foetuses [6] or chorionic villus sampling late in the first trimester of pregnancy [7]. …”

Chromosome distribution of early miscarriages with present or absent embryos: female predominance

“…And for women with recurrent miscarriages of chromosome anomaly, we could provide further pre-implantation genetic diagnosis in the following conceptions. Although the history of receiving ART (assisted reproductive technology) not being documented in our study, Qin et al reviewed 1896 cases and declared that ART treatment wouldn't increase the risk for chromosomal abnormalities in the first trimester miscarriages [11].…”

Traditional and molecular chromosomal abnormality analysis of products of conception in spontaneous and recurrent miscarriage

“…The abnormality rate is 53.0% (95% CI 44.8–61.3%), which is similar to that observed in spontaneous miscarriage (49.7%). In a meta‐analysis carried out by Qin et al, it was found that the frequency of chromosomal abnormality in early spontaneous miscarriages after ART was not significantly increased compared with those in natural conceptions. In addition, the frequency of chromosomal abnormality in early spontaneous miscarriages following in vitro fertilisation (IVF) was similar to those observed following ICSI.…”

“…Nowadays, multi-fluor FISH, in which each chromosome appears to be painted with a different colour, can quickly scan a set of chromosomes with limited resolution. In practice it is unusual to use the complete set of 24 probes; instead, between five and seven probes are selected for the chromosomes most commonly involved in aneuploidy (for example 13,14,15,16,18,21,22, and X). The resolution of FISH is 40-250 kb per probe for a single site.…”