Chromosomal abnormalities in spontaneous abortion after assisted reproductive treatment

Ji Won Kim,Sang Woo Lyu,Tae Ki Yoon,Hyun Ha Seok,You Shin Kim,Jung Hyun Cho,Woo Sik Lee,Sung Han Shim

doi:10.1186/1471-2350-11-153

Ji Won Kim, Sang Woo Lyu + Show 6 more

Open Access

https://doi.org/10.1186/1471-2350-11-153

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Abstract

BackgroundWe evaluated cytogenetic results occurring with first trimester pregnancy loss, and assessed the type and frequency of chromosomal abnormalities after assisted reproductive treatment (ART) and compared them with a control group. We also compared the rate of chromosomal abnormalities according to infertility causes in ICSI group.MethodsA retrospective cohort analysis was made of all patients who were referred to the Genetics Laboratory of Fertility Center of CHA Gangnam Medical Center from 2005 to 2009 because of clinical abortion with a subsequent dilation and evacuation (D&E) performed, and patients were grouped by type of conception as follows: conventional IVF (in vitro fertilization) (n = 114), ICSI (intracytoplasmic sperm injection) (n = 140), and control (natural conception or intrauterine insemination [IUI]) (n = 128). Statistical analysis was performed using SPSS software.ResultsA total 406 specimens were referred to laboratory, ten abortuses were excluded, and in 14 cases, we did not get any spontaneous metaphase, chromosomal constitutions of 382 specimens were successfully obtained with conventional cytogenetic methods. Overall, 52.62% of the miscarriages were found to be cytogenetically abnormal among all patients, the frequency was 48.4% in the control group, 54.3% of miscarriages after ICSI and 55.3% after conventional IVF (p = 0.503). The most prevalent abnormalities were autosomal trisomy, however, nine (11.69%) sex chromosome aneuploidy were noted in the ICSI group vs. four (6.45%) and two (3.23%) cases in the conventional IVF group and control group. We compared chromosomal abnormalities of miscarriages after ICSI according to infertility factor. 55.71% underwent ICSI due to male factors, 44.29% due to non-male factors. ICSI group having male factors showed significantly higher risk of chromosomal abnormalities than ICSI group having non-male factors (65.8% vs. 34.2%, p = 0.009, odds ratio = 1.529, 95% CI = 1.092-2.141).ConclusionsThere is no increased risk of chromosomal abnormalities due to ART was found with the exception of a greater number of sex chromosomal abnormalities in the ICSI group with male factor infertility. Therefore, these alterations could be correlated with the underlying parental risk of abnormalities and not with the ICSI procedure itself.

Highlights

We evaluated cytogenetic results occurring with first trimester pregnancy loss, and assessed the type and frequency of chromosomal abnormalities after assisted reproductive treatment (ART) and compared them with a control group
One study reported no increased risk of congenital malformation or major developmental delays associated with Intracytoplasmic sperm injection (ICSI) [12], and another showed that couples that underwent ART did not exhibit increased cytogenetic risks compared to a natural conception group, and no significant difference was seen in the incidence of chromosomal anomalies between ICSI and in vitro fertilization (IVF) [13]
Patients were grouped by the type of conception: conventional IVF, ICSI, and controls, which included nonviable spontaneous pregnancies from infertile couples who had not undergone ART and resulting from intrauterine insemination (IUI)

Summary

Introduction

We evaluated cytogenetic results occurring with first trimester pregnancy loss, and assessed the type and frequency of chromosomal abnormalities after assisted reproductive treatment (ART) and compared them with a control group. We compared the rate of chromosomal abnormalities according to infertility causes in ICSI group. Few reports have examined pregnancy outcomes after ART, and their results are inconclusive with regards to the risk of miscarriage and aneuploidy. One study reported no increased risk of congenital malformation or major developmental delays associated with ICSI [12], and another showed that couples that underwent ART did not exhibit increased cytogenetic risks compared to a natural conception group, and no significant difference was seen in the incidence of chromosomal anomalies between ICSI and in vitro fertilization (IVF) [13]

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