Chromosomal Analysis of 129 Miscarried Conceptuses: A Retrospective Study
Abstract Background Embryonic chromosomal abnormality is one of the significant causative factors of pregnancy loss. Our goal was to investigate the differences of chromosomal abnormality between different conception modes in miscarried products of conception (POCs). Methods A retrospective study included 129 miscarried POCs from 81 women undergoing assisted reproductive technology (ART) and 48 spontaneous pregnant (SP) women during March 2019 to March 2021 in Renmin Hospital of Wuhan University. Subgroups were divided according to age, fertilization method, types of embryo transfer. The profiles of cytogenetic abnormalities in the miscarried POCs were measured via next-generation sequencing. Results The total chromosomal abnormality rate was 65.1%. No significant difference was found in the rate of chromosomal abnormalities between ART and SP group (63% vs. 68.8%, P = 0.505). However, the rate of chromosomal structural abnormalities was significantly increased in ART group (P = 0.02). There was no significant difference in the rate of chromosomal abnormalities when stratified by age (62.9% vs. 71.9%, P = 0.355) and frequency of abortion (66.7% vs. 63.2%, P = 0.678). In the patients aged < 35 years, the ART group had more frequent structural abnormality than SP group (P = 0.006). In the patients aged ≥ 35 years, numerical chromosomal abnormality was predominated in both groups (P = 0.655). Compared with the IVF fertilization subgroup, microdeletion was more frequent in the ICSI fertilization subgroup (80% vs.28.6%, P = 0.013). The rate of chromosomal abnormality in the fresh embryo transfer group was significantly higher than that in the frozen embryo transfer group (92.3% vs.50%, P = 0.0001), especially the structural abnormality (46.2% vs. 15.4%, P = 0.016). Conclusion Chromosomal abnormality is the main cause of spontaneous abortion, whether in SP or in ART patients. The incidence of structural abnormalities in miscarried POCs from ART patients was significantly increased and fresh cycles had higher frequency of chromosomal abnormalities than the frozen cycles, hints us that “freezing all” should be considered in the process of assisted reproduction if encountered hyper ovarian stimulation, to avoid the negative effect of high estrogen environment on embryo development.