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Nikitina TV, Sazhenova EA, Tolmacheva EN, Sukhanova NN, Vasilyev SA, Lebedev IN. Comparative cytogenetics of anembryonic pregnancies and missed abortions in human. Vavilovskii Zhurnal Genet Selektsii 2023; 27:28-35. [PMID: 36923481 PMCID: PMC10009480 DOI: 10.18699/vjgb-23-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 03/11/2023] Open
Abstract
Miscarriage is an important problem in human reproduction, affecting 10-15 % of clinically recognized pregnancies. The cases of embryonic death can be divided into missed abortion (MA), for which the ultrasound sign of the embryo death is the absence of cardiac activity, and anembryonic pregnancy (AP) without an embryo in the gestational sac. The aim of this study was to compare the frequency of chromosomal abnormalities in extraembryonic tissues detected by conventional cytogenetic analysis of spontaneous abortions depending on the presence or absence of an embryo. This is a retrospective study of 1551 spontaneous abortions analyzed using GTG-banding from 1990 to 2022 (266 cases of AP and 1285 cases of MA). A comparative analysis of the frequency of chromosomal abnormalities and the distribution of karyotype frequencies depending on the presence of an embryo in the gestational sac was carried out. Statistical analysis was performed using a chi-square test with a p <0.05 significance level. The total frequency of chromosomal abnormalities in the study was 53.6 % (832/1551). The proportion of abnormal karyotypes in the AP and MA groups did not differ significantly and amounted to 57.1 % (152/266) and 52.9 % (680/1285) for AP and MA, respectively (p = 0.209). Sex chromosome aneuploidies and triploidies were significantly less common in the AP group than in the MA group (2.3 % (6/266) vs 6.8 % (88/1285), p = 0.005 and 4.9 % (13/266) vs 8.9 % (114/1285), p = 0.031, respectively). Tetraploidies were registered more frequently in AP compared to MA (12.4 % (33/266) vs. 8.2 % (106/1285), p = 0.031). The sex ratio among abortions with a normal karyotype was 0.54 and 0.74 for AP and MA, respectively. Thus, although the frequencies of some types of chromosomal pathology differ between AP and MA, the total frequency of chromosomal abnormalities in AP is not increased compared to MA, which indicates the need to search for the causes of AP at other levels of the genome organization, including microstructural chromosomal rearrangements, monogenic mutations, imprinting disorders, and epigenetic abnormalities.
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Affiliation(s)
- T V Nikitina
- Research Institute of Medical Genetics, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - E A Sazhenova
- Research Institute of Medical Genetics, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - E N Tolmacheva
- Research Institute of Medical Genetics, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - N N Sukhanova
- Research Institute of Medical Genetics, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - S A Vasilyev
- Research Institute of Medical Genetics, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - I N Lebedev
- Research Institute of Medical Genetics, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
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Volozonoka L, Gailite L, Perminov D, Kornejeva L, Fodina V, Kempa I, Miskova A. Reducing misdiagnosis caused by maternal cell contamination in genetic testing for early pregnancy loss. Syst Biol Reprod Med 2020; 66:410-420. [PMID: 33059488 DOI: 10.1080/19396368.2020.1827081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The analysis of products of conception (POC) is clinically important to establish the cause of early pregnancy loss. Data from such analyses can lead to specific interventions in subsequent natural or assisted conceptions. The techniques available to examine the chromosomal composition of POC have limitations and can give misleading results when maternal cell contamination (MCC) is overlooked. The aim of this study was to develop a protocol for MCC assessment and to formulate POC material handling, testing, and reporting recommendations. Using array comparative genomic hybridization, we tested 86 POC samples, of which 47 sample pairs (DNA extracted from the POC sample and maternal DNA) were assessed for the presence of MCC. MCC was evaluated using an approach we developed, which exploited the genotyping of 14 STR, AMEL, and SRY loci. POC samples showing the clear presence of villi (63.9%) did not contain any signs of the maternal genome and can therefore be reliably tested using conventional methods. The proportion of 46,XX karyotype in the unselected sample batch was 0.39, which fell to 0.23 in visually good samples and was 0.27 in samples having no signs of contamination upon MCC testing. MCC assessment can rescue visually poor samples from being discarded or wrongly genotyped. We demonstrate here that classification based on visual POC material evaluation and MCC testing leads to predictable and reliable POC genetic testing outcomes. Our formulated recommendations covering POC material collection, transportation, primary and secondary processing, as well as the array of pertinent considerations discussed here, can be implemented by laboratories to improve their POC genetic testing practices. We anticipate our protocol for MCC assessment and recommendations will help reduce the misconception regarding the etiology of miscarried fetuses and foster informed decision-making by clinicians and patients dealing with early pregnancy loss.
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Affiliation(s)
- Ludmila Volozonoka
- Scientific Laboratory of Molecular Genetics, Riga Stradins University , Riga, Latvia
| | - Linda Gailite
- Scientific Laboratory of Molecular Genetics, Riga Stradins University , Riga, Latvia
| | | | | | | | - Inga Kempa
- Scientific Laboratory of Molecular Genetics, Riga Stradins University , Riga, Latvia
| | - Anna Miskova
- Department of Obstetrics and Gynecology, Riga Stradins University , Riga, Latvia
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Karyotype evaluation of repeated abortions in primary and secondary recurrent pregnancy loss. J Assist Reprod Genet 2020; 37:517-525. [PMID: 32009222 DOI: 10.1007/s10815-020-01703-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/27/2020] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To study the contribution of embryo chromosomal abnormalities in primary and secondary recurrent pregnancy loss (RPL) and to analyze the recurrence of chromosomal constitution in miscarriages from the same couple. METHODS Retrospective study of abortion karyotypes in RPL families based on the mother's primary or secondary RPL status (563 embryo specimens, 335 samples from primary, and 228 samples from secondary RPL). RPL was defined as two or more consecutive miscarriages. One hundred eight cases of recurrent embryo/fetal loss in 51 families were analyzed to assess the probability of having the same karyotype pattern (recurrent normal or recurrent abnormal) in both previous and subsequent pregnancy loss. The karyotypes of abortions were established using standard cytogenetic analysis, as well as interphase fluorescence in situ hybridization (FISH) and comparative genomic hybridization (CGH). RESULTS The frequency of aberrations was 43.9% in abortions from primary RPL versus 52.6% in secondary RPL (p = 0.041). Women 35 years of age or older were the main contributors to this difference. The odds ratio of a subsequent abortion having the same karyotype pattern (normal or abnormal) as the previous one was 6.98 (p = 0.0013). CONCLUSION The frequency of abnormalities is higher in abortions from the secondary RPL versus primary RPL group, and this difference is due to the relative deficiency of miscarriages with abnormal karyotypes in older women with primary RPL. The probability of having the same karyotype pattern (recurrent normal or recurrent abnormal) in the previous and subsequent abortion is increased significantly compared with chance.
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Nikitina TV, Sazhenova EA, Tolmacheva EN, Sukhanova NN, Kashevarova AA, Skryabin NA, Vasilyev SA, Nemtseva TN, Yuriev SY, Lebedev IN. Comparative Cytogenetic Analysis of Spontaneous Abortions in Recurrent and Sporadic Pregnancy Losses. Biomed Hub 2016; 1:1-11. [PMID: 31988885 PMCID: PMC6945958 DOI: 10.1159/000446099] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The majority of miscarriages are sporadic; however, 1–5% of couples experience recurrent pregnancy loss (RPL). Approximately 50–60% of miscarriages result from chromosomal abnormalities. Currently, there are conflicting reports regarding the rates of chromosomal abnormalities between recurrent and sporadic pregnancy losses. Methods A retrospective comparative cytogenetic analysis of 442 RPL and 466 sporadic abortions (SA) was performed. Maternal age and medical background were evaluated, and chromosomal abnormality rates were compared between groups. Results The frequency of embryos with abnormal karyotypes was significantly higher in SA compared to RPL (56.7 and 46.6%, respectively), and abortions from women under 30 years of age were the main contributor to this difference. An age-dependent increase in the abnormal karyotype rate was observed in two groups of women - those with SA [53.0 and 70.1% for younger and older (≥35-year-old) mothers, respectively] and those with idiopathic RPL without any concomitant reproductive pathology (46.5 and 78.4% for younger and older mothers) - but not in the group of women with RPL associated with concomitant reproductive pathology. The incidence of recurrent abnormal karyotypes in subsequent miscarriages was significantly higher than random probability (odds ratio = 22.75). Conclusion Our findings highlight the variability in the risk of aneuploidy in recurrent abortion.
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Affiliation(s)
- Tatiana V Nikitina
- Laboratory of Cytogenetics, Institute of Medical Genetics, Siberian State Medical University, Tomsk, Russia
| | - Elena A Sazhenova
- Laboratory of Cytogenetics, Institute of Medical Genetics, Siberian State Medical University, Tomsk, Russia
| | - Ekaterina N Tolmacheva
- Laboratory of Cytogenetics, Institute of Medical Genetics, Siberian State Medical University, Tomsk, Russia
| | - Natalia N Sukhanova
- Laboratory of Cytogenetics, Institute of Medical Genetics, Siberian State Medical University, Tomsk, Russia
| | - Anna A Kashevarova
- Laboratory of Cytogenetics, Institute of Medical Genetics, Siberian State Medical University, Tomsk, Russia.,Laboratory of Ontogenetics, Tomsk State University, Siberian State Medical University, Tomsk, Russia
| | - Nikolay A Skryabin
- Laboratory of Cytogenetics, Institute of Medical Genetics, Siberian State Medical University, Tomsk, Russia.,Laboratory of Ontogenetics, Tomsk State University, Siberian State Medical University, Tomsk, Russia
| | - Stanislav A Vasilyev
- Laboratory of Cytogenetics, Institute of Medical Genetics, Siberian State Medical University, Tomsk, Russia.,Laboratory of Ontogenetics, Tomsk State University, Siberian State Medical University, Tomsk, Russia
| | - Tatiana N Nemtseva
- Center of Perinatal Health, Siberian State Medical University, Tomsk, Russia
| | - Sergey Y Yuriev
- Center of Perinatal Health, Siberian State Medical University, Tomsk, Russia.,Departments of Obstetrics and Gynecology, Siberian State Medical University, Tomsk, Russia
| | - Igor N Lebedev
- Laboratory of Cytogenetics, Institute of Medical Genetics, Siberian State Medical University, Tomsk, Russia.,Laboratory of Ontogenetics, Tomsk State University, Siberian State Medical University, Tomsk, Russia.,Departments of Medical Genetics, Siberian State Medical University, Tomsk, Russia
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Cheng HH, Ou CY, Tsai CC, Chang SD, Hsiao PY, Lan KC, Hsu TY. Chromosome distribution of early miscarriages with present or absent embryos: female predominance. J Assist Reprod Genet 2014; 31:1059-64. [PMID: 24879519 DOI: 10.1007/s10815-014-0261-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 05/13/2014] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The objective of this study is to compare the chromosomal distribution of early miscarriages with or without embryonic poles. MATERIALS AND METHODS It was a retrospective study of 223 women who underwent dilation and curettage (D&C) between 1995 and 2013 for early miscarriages. The presence or absence of a fetal pole was evaluated by abdominal or transvaginal ultrasound. Cytogenetic tests of products of conception following culture were determined in both groups. RESULTS Of the 223 early miscarriages, 143 had embryos and 80 did not. The abnormality rate differed significantly (61.5 % vs. 46.3 %, p < 0.05), with trisomy 18, 21 and 45X found only in miscarriages with embryos. There were no significant differences between groups in rates of triploidy, tetraploidy, mosaicism, structure and double abnormality. The female abortus rate was higher in miscarriages with or without embryonic poles, as well as in groups with normal and abnormal karyotypes. CONCLUSIONS Chromosome distribution differs in miscarriages with or without embryonic poles. The ultrasound findings might offer different direction to determine the causes of early miscarriages. The higher female abortus rate may be associated with early selection.
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Affiliation(s)
- Hsin-Hsin Cheng
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Ta-Pei Road, Niao-Sung Dist., Kaohsiung, 833, Taiwan,
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Mathur N, Triplett L, Stephenson MD. Miscarriage chromosome testing: utility of comparative genomic hybridization with reflex microsatellite analysis in preserved miscarriage tissue. Fertil Steril 2014; 101:1349-52. [PMID: 24636399 DOI: 10.1016/j.fertnstert.2014.02.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Revised: 01/19/2014] [Accepted: 02/05/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the utility of comparative genomic hybridization (CGH) and reflex microsatellite analysis (MSA) for chromosome analysis of preserved miscarriage tissue. DESIGN Observational study. SETTING Academic recurrent pregnancy loss program. PATIENT(S) Patients with recurrent early pregnancy loss, defined as two or more miscarriages at <10 weeks, and at least one preserved miscarriage specimen sent for CGH. INTERVENTION(S) Preserved miscarriage specimens were sent for CGH. If results were euploid female (46,XX), reflex MSA was performed to assess if the result was of miscarriage or maternal origin. MAIN OUTCOME MEASURE(S) Results were recorded as either informative or uninformative. Uninformative results were classified as "CGH failed" or "maternal contamination." RESULT(S) Fifty-eight women with 77 miscarriage specimens met the criteria. CGH failed in nine of the preserved miscarriage specimens owing to minimal pregnancy tissue, and two owing to poor-quality DNA. Twenty-two of the 33 specimens reported as 46,XX by CGH were sent for MSA; maternal contamination was confirmed in 23% (5/22). CGH was therefore informative in 79% (61/77) of the specimens; 64% (39/61) were euploid, and 36% (22/61) were noneuploid, with a 46,XX/46,XY ratio of 2.5. CONCLUSION(S) CGH with reflex MSA is useful for obtaining chromosome results in preserved miscarriage specimens, although informative results were achieved in only 79% of specimens. Maternal contamination should be assessed after an initial diploid female result.
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Affiliation(s)
- Nidhee Mathur
- Department of Obstetrics and Gynecology, University of Chicago Recurrent Pregnancy Loss Program, University of Chicago, Chicago, Illinois
| | - Latrice Triplett
- Department of Obstetrics and Gynecology, University of Chicago Recurrent Pregnancy Loss Program, University of Chicago, Chicago, Illinois
| | - Mary D Stephenson
- Department of Obstetrics and Gynecology, University of Chicago Recurrent Pregnancy Loss Program, University of Chicago, Chicago, Illinois; Department of Obstetrics and Gynecology, University of Illinois, Chicago, Illinois.
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Tolmacheva EN, Kashevarova AA, Sukhanova NN, Sazhenova EA, Lebedev IN. Epigenetic inactivation of the RB1 gene as a factor of genomic instability: A possible contribution to etiology of chromosomal mosaicism during human embryo development. RUSS J GENET+ 2009. [DOI: 10.1134/s1022795408110033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Borovik CL, Perez ABA, Silva LRD, Krepischi-Santos ACV, Costa SS, Rosenberg C. Array-CGH testing in spontaneous abortions with normal karyotypes. Genet Mol Biol 2008. [DOI: 10.1590/s1415-47572008000300004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Current awareness in prenatal diagnosis. Prenat Diagn 2005; 25:971-6. [PMID: 16270411 DOI: 10.1002/pd.1024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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