Prevalence of Cytogenetic Anomalies in Couples with Recurrent Miscarriages: A Case-control Study

Genetic Counselling: the biomedical bridge between molecular diagnosis and precision treatment

Background

Since the development of genomics, we are able to understand backgrounds of differential pathogenicity of metabolic disorders. Molecular diagnosis has become inevitable for metabolic, neuro-psychiatric and genetic disorders due to highly overlapping pathophysiological symptoms. The present lacuna between clinical prescription and molecular diagnosis is very prominent and can only be filled up through experts who can function as the bridge in between.

Main body

In this present review, the authors tried to focus on the role of genetic counselors in disease diagnosis as well as scopes of disease biology in utilizing the expertise of genetic professional for precision treatments of patients. We summarized four major disease areas, Cancer management, Obstetrics and Gynecology, Newborn Screening and Rare Genetic Disorders, where molecular diagnosis and genetic counseling can highly support the clinicians in precision treatment of the patients. Idiopathic reproductive failures, clinically overlapping neuro-psychiatric disorders, chromosomal aberrations in progressing tumors, rare genetic disorders all the disease areas can find out fruitful intervention when enlightened with molecular diagnosis and genetic counseling. Though, genetic counseling is commonly practiced in intervening reproductive problems, newborn screening and cancer, still the scope of genetic counselor in successfully intervening multiple rare genetic diseases as well as common hereditary life style disorders, remain extremely high.

Conclusion

The liaison between clinicians and geneticists, specifically clinical prescription and genetic diagnosis is one of the key demands of present age, which can be successfully fulfilled by the genetic counselors. For these reasons, genetic counseling is predicted as the biomedical career of future due to being in the vital position for successful implementation of precision medicine.

Chromosomal abnormalities of 19,000 couples with recurrent spontaneous abortions: a multicenter study

OBJECTIVE

To investigate the demographic data and karyotypes of 19,000 couples who experienced recurrent spontaneous abortion (RSA).

DESIGN

A cross-sectional study of 19,000 couples.

SETTING

Five hospitals.

PATIENT(S)

A total of 19,000 couples experiencing RSA.

INTERVENTION(S)

Not applicable.

MAIN OUTCOME MEASURE(S)

Cytogenetic analysis of blood lymphocytes.

RESULT(S)

A total of 844 couples (4.44%) showed chromosomal aberrations in either partner. Females were more likely to have chromosomal aberrations. The mean age of females and males with chromosomal aberrations was younger than that of females and males without chromosomal aberrations. Interestingly, sex and age distribution varied significantly depending on the subtypes of chromosomal aberrations. We detected 324 balanced translocations, including 223 novel ones. They were distributed across all chromosomes; the frequency of balanced translocations decreased according to the numerical order of autosomes (strong negative correlation; r = -0.84). Individuals with balanced translocations were younger than other groups. All 58 inversions, including 25 novel ones, were detected in autosomes; the negative correlation also existed. Thirteen Robertsonian translocations, 5 deletions, and 3 duplications were detected. Six types of Turner variants, triple X mosaicism, and mosaic Down syndrome were detected in females; Klinefelter variants and mosaic XYY syndrome were detected in males. Marker chromosomes at various mosaic levels and 7 different complex chromosomal rearrangements were also observed.

CONCLUSION(S)

Patients who experienced RSA induced by chromosomal aberrations experienced miscarriages at a younger age. Significant correlations existed between the patients' age or sex and the subtypes of chromosomal aberrations. This study detected several chromosomal abnormalities associated with RSA, including various novel aberrations.

Cytogenetic Analysis of 570 Couples with Recurrent Pregnancy Loss: Reporting 11 Years of Experience

Objectives

Recurrent pregnancy loss (RPL) is a serious complication of pregnancies, affecting almost 2%-5% of couples. Among numerous underlying causes, chromosomal anomalies in one of the partners are regarded as important issues, with varying frequencies among different populations. In this study, we aimed to determine the prevalence of chromosomal abnormalities and chromosome polymorphisms in couples with a history of RPL from Kermanshah province, west of Iran.

Materials and Methods

In this 11-year retrospective study, a total of 1140 cases with two or more spontaneous abortions were recruited and studied according to standard cytogenetic analysis.

Results

From a total of 1140 reviewed blood samples, 1011 people (88.5%) had a normal karyotype and 129 people (11.5%) had chromosomal aberrations. These aberrations were found in 62 females and 67 males. The prevalence of chromosomal abnormalities was as follows: 18 (1.5%) structural aberrations, 1 numerical anomaly and 110 (9.6%) apparently normal polymorphic variants.

Conclusions

Our findings could determine the underlying cause of RPL in 1.5% of the population while the majority still remained unexplained. This emphasizes the importance of searching for other genetic and nongenetic causes of RPL in apparently idiopathic cases of RPL.