Abstract
Purpose: To determine if careful specimen selection and washing of tissue from first trimester missed abortion products of conception specimens increases the sensitivity of routine cytogenetics in detecting aneuploidy.
Methods: Retrospective review of cytogenetics results from tissue from dilation and curettage for missed abortion in a university fertility practice between 1998 and 2001. A technique of careful selection and washing of the specimen was implemented in July 1999. Results from before (n = 15) and after (n = 41) this change were compared. Cytogenetics reports from other physicians using the same laboratory were used for comparison (n = 59).
Results: The percentage of 46XX results was significantly decreased in the test group when compared to historical and community controls: 29% vs. 73% and 56% respectively. The percentage of aneuploid results was significantly higher in the test group at 61% vs. 7% and 36% in the historical and community controls respectively.
Conclusion: Thorough separation and cleaning of villi prior to sending missed abortion specimens significantly increases sensitivity of conventional cytogenetics for detecting aneuploidy by decreasing maternal contamination.
Keywords: Cytogenetics, maternal contamination, missed abortion, villi
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REFERENCES
- 1.Bell KA, Van Deerin PG, Haddad BR, Feinberg RF. Cytogenetic diagnosis of “normal 46XX” karyotypes in spontaneous abortions frequently may be misleading. Fertil Steril. 1999;72:334–341. doi: 10.1016/s0015-0282(98)00445-2. [DOI] [PubMed] [Google Scholar]
- 2.Lomax B, Tang S, Separovic E, Phillips D, Hillard E, Thompson T, Kalousek DK. Comparative genomic hybridization in combination with flow cytometry improves results of cytogenetic analysis. Am J Hum Genet. 2000;66:1516–1521. doi: 10.1086/302878. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Jarrett KL, Michaels RC, Phelan MC, Vincent VA, Best RG. Microsatellite analysis reveals a high incidence of maternal cell contamination in 46XX products of conception consisting of villi or a combination of villi and membranous material. Am J Obstet Gynecol. 2001;185:198–203. doi: 10.1067/mob.2001.114692. [DOI] [PubMed] [Google Scholar]
- 4.Stern JJ, Cerillo M, Dorfmann AD, Coulam CB, Gutierrez-Najar AJ. Frequency of abnormal karyotypes among abortuses from women with and without a history of recurrent spontaneous abortion. Fertil Steril. 1996;65:250–253. doi: 10.1016/s0015-0282(16)58079-0. [DOI] [PubMed] [Google Scholar]
- 5.Ogasawara M, Aoki K, Okada S, Suzumori K. Embryonic karyotype of abortuses in relation to the number of previous miscarriages. Fertil Steril. 2000;73:300–304. doi: 10.1016/s0015-0282(99)00495-1. [DOI] [PubMed] [Google Scholar]
- 6.Carp H, Toder V, Aviram A, Daniely M, Mashiach S, Barkai G. Karyotype of the abortus in recurrent miscarriage. Fertil Steril. 2001;75:678–682. doi: 10.1016/s0015-0282(00)01801-x. [DOI] [PubMed] [Google Scholar]
- 7.Ghazeeri GS, Kutteh WH. Immunologic testing and treatment in reproduction: Frequency assessment of practice patterns at assisted reproduction clinics in the USA and Australia. Hum Reprod. 2001;16:2130–2135. doi: 10.1093/humrep/16.10.2130. [DOI] [PubMed] [Google Scholar]
- 8.Antiphospholipid syndrome. ACOG Educational and Practice Bulletin #244, February 1998