Idiopathic recurrent miscarriage is caused mostly by aneuploid embryos

Objective: To determine any beneficial effects of preimplantation genetic screening (PGS) of all chromosomes by array comparative genomic hybridization (aCGH), with either day 3 or blastocyst biopsy, for idiopathic recurrent pregnancy loss (RPL) patients compared with their expected loss rate. Design: Case series report. Setting: Multiple fertility centers. Patient(s): A total of 287 cycles of couples with idiopathic RPL (defined as two or more losses). Intervention(s): PGS was done with day 3 biopsy (n = 193) or blastocyst biopsy (n 94), followed by analysis with aCGH. Main Outcome Measure(s): Spontaneous abortion rate, euploidy rate. Result(s): A total of 2,282 embryos were analyzed, of which 35% were euploid and 60% were aneuploid. There were 181 embryo transfer cycles, of which 100 (55%) became pregnant with an implantation rate of 45% (136 sacs/299 replaced embryos) and 94 pregnancies (92%) were ongoing (past second trimester) or delivered. The miscarriage rate was found to be only 6.9% (7/102), compared with the expected rate of 33.5% in an RPL control population and 23.7% in an infertile control population. Conclusion(s): Current PGS results with aCGH indicate a significant decrease in the miscarriage rate of idiopathic RPL patients and high pregnancy rates. Furthermore, this suggests that idiopathic recurrent miscarriage is mostly caused by chromosomal abnormalities in embryos. (Fertil Steril (R) 2012; 98: 675-80. (C) 2012 by American Society for Reproductive Medicine.)