Reproductive outcome and fetal karyotype of couples with recurrent miscarriages.

PURPOSE: The purpose of this study was to evaluate the relationship between fetal karyotype and parental chromosomal abnormalities, and assess the long-term reproductive outcomes in couples with recurrent miscarriages (RM).

MATERIALS AND METHODS: The reproductive outcomes of 34 couples with abnormal karyotypes and RM were investigated. Ultrasound examinations were performed during pregnancy, fetal karyotypes were determined following miscarriages, and successful pregnancy outcomes were recorded.

RESULTS: Of the 34 couples, 20 individuals presented with chromosomal abnormalities, specifically in nine females and 11 males (45% vs 55%, chi2 = 0.2833,p > 0.05). Fifteen couples (44.1%) possessed karyotype polymorphisms, of which the most common variant was a long Y chromosome in males. The reproductive outcomes of subsequent pregnancies consisted of 25 live births of phenotypically normal infants (73.5%), one infant with multiple malformations (2.9%), and eight RM (23.6%). With regards to karyotypes, 69.2% (9/13) of couples had inversions and 73.3% (11/15) had karyotype polymorphisms that resulted in live births of phenotypically normal babies. Fetal karyotyping was performed in a total of 29 cases. Normal karyotypes were present in 48.3% (14/29) of cases, whereas 41.4% (12/29) had abnormalities (either numerical or structural), and 10.3% (3/29) has a karyotype polymorphism.

CONCLUSIONS: There is a positive correlation between chromosomal abnormalities and spontaneous miscarriages. A complete evaluation and special treatment should be provided to couples with a history of recurrent miscarriage(s) during a subsequent pregnancy, particularly when one partner is a carrier of chromosome abnormalities (i.e., inversions of chromosome 9 and long Y chromosome in males). Prenatal diagnosis is necessary in carrier couples suffering from more than two miscarriages.