Abstract
Missed abortion is one of the common complications of assisted reproductive technology (ART). Genetic abnormality is the most important factor. However, the effect of ART on the molecular karyotype of products of conception (POC) remains unknown. We explored the effect of ART on the molecular karyotype of POC in miscarriage. POC were obtained from women undergoing ART. Single nucleotide polymorphism (SNP) microarray was used to analyze the molecular karyotype. A total of 1493 POC were collected for SNP array analysis. The total rate of karyotypic abnormalities was 63.1% (943/1493). The proportion of karyotypic abnormalities was 70.4% (193/416) in >35-year-old group, which was significantly higher than that (60.6%) (343/566) in <30-year-old group and that (60%) (307/511) in the 30–35-year-old group. In natural conception (NC) group, the proportion of karyotypic abnormalities was 64.6% (201/311), whereas in ART group it was 62.7% (742/1182) and, there was no significant difference. The ratio between male and female fetuses was 1:1.13 (698/795). The rate of karyotypic abnormalities in male was 62.9% (439/698) and that in female was 63.4% (504/795), and these values did not differ significantly (P=0.84). Molecular karyotypic abnormality is the most important reason in miscarriage, and female age is a significant factor influencing the karyotypic abnormalities. Comparison with NC, ART, and gender of aborted embryos may not increase the rate of molecular karyotypic abnormality in miscarriage.
Highlights
With the development of assisted reproductive technology (ART) and its wide applications, the pregnancy rate has greatly improved, but the live birth rate has not significantly improved, raising increasing attention on the clinical outcomes of ART pregnancy
Attention to missed abortion in ART pregnancy, analysis of the possible causes, and application of effective prevention and treatment measures are of great significance in increasing the clinical ART pregnancy rate, reducing birth defects, and improving the clinical prognosis
According to the U.S Centers for Disease Control and Prevention (CDC), in 62228 cases of clinical ART pregnancy, the spontaneous abortion rate is 14.7%, which does not differ significantly from the spontaneous abortion rate for natural conception (NC) in the 12–44-year-old population, suggesting that ART treatment does not increase the rate of spontaneous abortion [3]
Summary
With the development of assisted reproductive technology (ART) and its wide applications, the pregnancy rate has greatly improved, but the live birth rate has not significantly improved, raising increasing attention on the clinical outcomes of ART pregnancy. Missed abortion reduces the clinical pregnancy rate of ART and increases the psychological and economic burden of couples undergoing ART treatment. Attention to missed abortion in ART pregnancy, analysis of the possible causes, and application of effective prevention and treatment measures are of great significance in increasing the clinical ART pregnancy rate, reducing birth defects, and improving the clinical prognosis. The methods for evaluating the chromosomes of spontaneously aborted embryos are mainly as follows: karyotype analysis of chorionic villous cells, fluorescence in situ hybridization (FISH), and chromosomal microarray analysis (CMA). CMA is recommended as the preferred method for the detection of congenital dysplasia and congenital malformations by the International Standards for Cytogenomic Arrays Consortium [1]
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