Pregnancy loss is common with approximately 25% of all pregnancies resulting in a miscarriage. Approximately 10% for women in the age group of 20-35 and nearly 50% for women in the age group of 35-40 yrs of age have a bad obstetric history or miscarriage. The risk of miscarriages increases with advancing maternal age.
Following tests are offered to evaluate recurrent pregnancy loss:
- Cytogenetic testing of products of conception:
More than 60% of early miscarriages result from chromosome abnormalities. Following testing options are available for products of conceptions:
(a) Conventional karyotype analysis: detects aneuploidy (extra or missing chromosomes) and gross unbalanced abnormalities. Traditional option giving information about all chromosomes but chances of no result because of no growth and culture contamination.
(b) FISH on uncultured cells: detects most common aneuploidies and offers answers in the event of culture failure by conventional karyotype analysis. An economical option with information of the most common cause.
(c) Chromosomal microarray analysis (CMA): detects aneuploidy, unbalanced translocations and submicroscopic microdeletions and duplications in the genome. Best option with the highest yield of the cause of miscarriage.
- Peripheral blood karyotype of parents:
To evaluate the cause of recurrent pregnancy loss, parents should undergo peripheral blood karyotype analysis in order to detect if either is a carrier of a balanced structural chromosome abnormalities. Balanced translocations are found in about 5% of couples with recurrent miscarriages. This testing allows prediction and options for testing for subsequent pregnancies.