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Chapter 7 - The Uncertain Science of Preimplantation Genetic Testing for Reproduction

Published online by Cambridge University Press:  16 April 2025

By
Mayumi Sugiura-Ogasawara ,
Takeshi Sato ,
Shinobu Goto  and
Hiroyuki Yoshihara
Edited by
Roy G. Farquharson ,
Mary D. Stephenson  and
Mariëtte Goddijn
Roy G. Farquharson
Affiliation:
Liverpool Women’s Hospital
Mary D. Stephenson
Affiliation:
University of Illinois, Chicago
Mariëtte Goddijn
Affiliation:
Amsterdam University Medical Centers
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Summary

Unexplained recurrent pregnancy loss (RPL) includes non-euploid and euploid miscarriages but, unfortunately, are seldom identified as such because miscarriages are seldom karyotyped. There are few established treatments for unexplained RPL. Even if a factor is not identified, 80% of patients with two previous miscarriages can give birth, 70% if three miscarriages, 60% if four miscarriages, 50% if five miscarriages, 85% cumulatively. A 32 year old patient with RPL has an 85% likelihood of giving birth. Preimplantation genetic testing for aneuploidy (PGT-A) has no evidence of improvement in live birth rate. Molecular karyotyping of biopsied cells might be different from those of the inner cell mass due to mosaicism. Disruption by biopsy may reduce pregnancy rate. Subsequent pregnancy outcomes in patients with unexplained RPL who did not undergo PGT-A are important to publish for comparison.

Keywords

recurrent pregnancy lossrecurrent miscarriagepreimplantation genetic testing for aneuploidy
Type
Chapter
Information
Early Pregnancy , pp. 57 - 69
Publisher: Cambridge University Press
Print publication year: 2025

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