OBJECTIVE: To assess the use of MVA and DNA technologies for overcoming pitfalls associated with chromosome testing of miscarriages. DESIGN: Prospective cohort. MATERIALS AND METHODS: With IRB approval, women with ≥2 miscarriages of <10 wks, seen between 06/2004-07/2008, were identified. Prior to consultation, chromosome testing of miscarriages consisted of cytogenetic analysis only. Subsequently, pregnancy was defined as a +ve hCG drawn at 4 wks. Miscarriage tissue was obtained by office MVA, isolated by the clinician and sent for cytogenetic analysis. With 46,XX, microsatellite testing was performed, which compared highly polymorphic loci in the miscarriage DNA to the woman's DNA. If MCC was confirmed, comparative genomic hybridization (CGH) was performed on cryopreserved miscarriage tissue. Fisher's exact test and 95% confidence intervals for binomial proportions were reported. RESULTS: Success rates (livebirths and ongoing pregnancies >14 wks) prior and subsequent to consultation were 12% (187/1559) and 58% (195/337), respectively. Table 1 Prior Subsequent RPL subjects 368 251 Mean age at miscarriage 33 yrs (16-45) 36 yrs (27-46) Miscarriages <10 wks 1173 122 Miscarriages sent for chromosome testing 18% (211/1173) 55% (67/122) Culture failure 9% (19/211) 1% (1/67) p=0.05 MCC Unknown 20% (3/15) ∗ Aneuploid/Polyploid 37.5% (72/192) 50.8% (31/61) Euploid 62.5% (120/192) 49.2% (30/61) Ratio of 46,XX / 46,XY 2.2 (82/38) 1.1 (16/14) Proportion of 46,XX 68% (82/120) (59, 77%) 53% (16/30) (34, 72%) ∗ 15 of 19 46,XX miscarriages available for testing CONCLUSIONS: Prior to consultation, few miscarriages were sent for chromosome testing. Of those, there was a disproportionate number of 46,XX results, most likely due to MCC. With MVA, isolation of the miscarriage tissue, and DNA technologies when indicated, the 46,XX/46XY ratio normalized. Accurate chromosome testing of miscarriages requires rigorous handling techniques, conventional cytogenetic analysis and the judicious use of DNA technologies.</P>
Fertility and Sterility – Elsevier
Published: Sep 1, 2009
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera