Although most couples are blissfully unacquainted with the statistics surrounding miscarriage, pregnancy loss is really quite common, with 10-25% of recognized pregnancies ending in miscarriage. Assuming you have suffered a pregnancy loss or are currently in the process of having a miscarriage, you may well be wondering what caused the loss and worry about whether it’ll happen again. This short article aims to answer the next questions:

What causes miscarriage?
How common is pregnancy loss?
Which kind of genetic testing is available for miscarriage tissue?
How do chromosome testing help?
Causes of Miscarriage

There are many different explanations why miscarriage occurs, but the most typical cause for first trimester miscarriage is really a chromosome abnormality. Chromosome abnormalities – extra or missing whole chromosomes, also called “aneuploidy” – occur due to a mis-division of the chromosomes in the egg or sperm involved with a conception. Typically, humans have 46 chromosomes which come in 23 pairs (22 pairs numbered from 1 to 22 and the sex chromosomes, X and Y). For a child to develop normally it is essential that it have exactly the right quantity of chromosome material; missing or extra material at the time of conception or in an embryo or fetus could cause a female to either not get pregnant, miscarry, or have a child with a chromosome syndrome such as Down syndrome.

Over 50% of most first trimester miscarriages are caused by chromosome abnormalities. This number may be closer to 75% or higher for women aged 35 years and over who’ve experienced recurrent pregnancy loss. Overall, the rate of chromosome abnormalities and the rate of miscarriage both increase with maternal age, with a steep increase in women older than 35.

Pregnancy Loss – How Common could it be?

Miscarriage is a lot more common than most people think. Up to one in every four recognized pregnancies is lost in first trimester miscarriage. The opportunity of experiencing a miscarriage also increases as a mother gets older.

Most women who experience a miscarriage go on to possess a healthy pregnancy and never miscarry again. However, some women appear to be more prone to miscarriage than others. About five percent of fertile couples will experience two or more miscarriages.

Of note, the rate of miscarriage appears to be increasing. One reason for this can be awareness – more women know they’re having a miscarriage because home pregnancy tests have improved early pregnancy detection rates over the past decade, whereas in the past the miscarriage would have appeared to be just a unique period. Another reason could be that more women are conceiving at older ages.

stillbirth Types of Genetic Testing Ideal for Miscarriages

Genetic testing actually refers to many types of testing that you can do on the DNA in a cell. For miscarriage tissue, also called products of conception (POC), the most useful type of test to perform is really a chromosome analysis. A chromosome analysis (also known as chromosome testing) can examine all 23 pairs of chromosomes for the current presence of extra or missing chromosome material (aneuploidy). Because so many miscarriages are caused by aneuploidy, chromosome analysis on the miscarriage tissue could identify the reason for the pregnancy loss.

The most common approach to chromosome analysis is named karyotyping. Newer methods include advanced technologies such as for example microarrays.

Karyotyping analyzes all 23 pairs of chromosome but requires cells from the miscarriage tissue to first be grown in the laboratory, an activity called “cell culture”. For this reason requirement, tissue that’s passed at home is often unable to be tested with this particular method. About 20% or even more of miscarriage samples neglect to grow and thus no results are available. Additionally, karyotyping struggles to tell the difference between cells from mom (maternal cells) and cells from the fetus. In case a normal female result is found, it may be the correct result for the fetus or it may be maternal cell contamination (MCC) in which the result actually originates from testing the mother’s cells present in the pregnancy tissue instead of the fetal cells. MCC seems to occur in about 30% or even more of the samples tested by traditional karyotype. Results from karyotyping usually have a few weeks to months another from the laboratory.

Microarray testing is really a new kind of genetic testing done on miscarriage samples; the two most common types of microarray testing are array CGH (comparative genomic hybridization) and chromosome SNP (single-nucleotide polymorphism) microarray. Microarray testing is also in a position to test all 23 pairs of chromosomes for aneuploidy, but will not require cell culture. Therefore, you’re more likely to receive results and the results are typically returned faster when microarray testing is used. Additionally, some laboratories are collecting a sample of the mother’s blood simultaneously the miscarriage tissue is sent to enable immediate detection of maternal cell contamination (MCC).

Chromosome Testing – How can it help?

If a chromosome abnormality is identified, the kind of abnormality found could be assessed to help answer the question: “Will this eventually me again?”. Usually, chromosome abnormalities within an embryo or fetus are not inherited and have a minimal chance to occur in future pregnancies. Sometimes, a specific chromosome finding in a miscarriage alerts your doctor to do further studies to research the possibility of an underlying genetic or chromosome problem in your family that predisposes you to have miscarriages.

Furthermore, if a chromosome abnormality is identified it could prevent the need for other, sometimes quite costly, studies your doctor might consider to investigate the cause of the miscarriage.

Lastly, knowing the explanation for a pregnancy loss might help a couple start the emotional healing process, moving at night question of “Why did this happen to me?”.

Chromosome testing can be especially important for patients with repeated miscarriages, as it could either give clues to an underlying chromosomal cause for the miscarriages or eliminate chromosome errors as the reason behind the miscarriages and allow their doctor to pursue other styles of testing. For couples with multiple miscarriages determined to have a chromosomal cause, in vitro fertilization (IVF) with preimplantation genetic diagnosis (PGD) testing might be able to help increase their chances of having a successful healthy pregnancy.