Karyotype of the abortus in recurrent miscarriage

Objective: To assess the chromosomal aberrations in the abortus in recurren t miscarriage and the live birth rate after a euploid or aneuploid miscarri age. Design: Retrospective analysis. Setting: Tertiary referral unit in university hospital. Patient(s): One hundred sixty-seven patients with 3 to 16 miscarriages befo re 20 weeks. Intervention(s): Material collected at curettage from 167 abortuses was ana lyzed by standard G-banding techniques. Main Outcome Measure(s): The incidence of aberrations and the outcome of th e subsequent pregnancy were assessed according to the embryonic karyotype. Result(s): In this study 125 specimens were successfully karyotyped. Of the se, 29% (36 of 125) had chromosome aberrations. 94% of the aberrations were aneuploidy, and 6% were structural. The most prevalent anomalies sere chro mosome 16, 18, and 21 trisomies, triploidy, and monosomy X. After an aneupl oid miscarriage. there was a 68% subsequent live birth rate (13 of 19) comp ared to the 41% (16 of 39) rate after a euploid abortion. Conclusion(s): The low (29%) incidence of aberrations indicates that altern ative mechanisms may be responsible for the majority of recurrent miscarria ges. These figures provide a basis for assessing the efficacy of therapy fo r recurrent miscarriage. If further studies confirm that patients with kary otypically abnormal fetuses have a good prognosis, an informed decision can be made as to whether further investigations and treatment should be under taken (C) 2001 by American Society for Reproductive Medicine.