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. Should you have suffered a pregnancy loss or are currently in the process of experiencing a miscarriage, you may be wondering what caused the loss and worry about whether it will happen again. This short article aims to answer the following questions:

What causes miscarriage?
How common is pregnancy loss?
Which kind of genetic testing can be acquired 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 a chromosome abnormality. Chromosome abnormalities – extra or missing whole chromosomes, also known as “aneuploidy” – occur due to a mis-division of the chromosomes in the egg or sperm involved in a conception. Typically, humans have 46 chromosomes which come in 23 pairs (22 pairs numbered from 1 to 22 and then the sex chromosomes, X and Y). For a child to develop normally it is crucial that it have exactly the right amount of chromosome material; missing or extra material during conception or within an embryo or fetus could cause a female to either not become pregnant, miscarry, or have a child with a chromosome syndrome such as for example Down syndrome.

Over 50% of most first trimester miscarriages are due to chromosome abnormalities. This number could 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 far more common than a lot of 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 ages.

Most women who experience a miscarriage continue to have a healthy pregnancy rather than miscarry again. However, some women seem to be more susceptible to miscarriage than others. About five percent of fertile couples will experience several miscarriages.

Of note, the rate of miscarriage seems to be increasing. One reason for this may 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 may be that more women are conceiving at older ages.

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 known as products of conception (POC), the most useful type of test to execute is a chromosome analysis. A chromosome analysis (also known as chromosome testing) can examine all 23 pairs of chromosomes for the presence of extra or missing chromosome material (aneuploidy). Because so many miscarriages are due to aneuploidy, chromosome analysis on the miscarriage tissue can often identify the reason behind the pregnancy loss.

The most common method of chromosome analysis is called karyotyping. Newer methods include advanced technologies such as microarrays.

Karyotyping analyzes all 23 pairs of chromosome but requires cells from the miscarriage tissue to first be grown in the laboratory, a process called “cell culture”. For that reason requirement, tissue that is passed at home is often unable to be tested with this particular method. About 20% or more of miscarriage samples fail to grow and thus no email address details are available. Additionally, karyotyping is unable to tell the difference between cells from mom (maternal cells) and cells from the fetus. In case a normal female result is available, it may be the right result for the fetus or it might be maternal cell contamination (MCC) where the result actually comes 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 to come back from the laboratory.

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

Chromosome Testing – How do it help?

In case a chromosome abnormality is identified, the kind of abnormality found can be assessed to help answer fully the question: “Will this happen to me again?”. Usually, chromosome abnormalities in an embryo or fetus aren’t inherited and have a low possiblity to occur in future pregnancies. Sometimes, a particular chromosome finding in a miscarriage alerts your doctor to do further studies to research the chance of an underlying genetic or chromosome problem in your family that predisposes one to have miscarriages.

Furthermore, in case a chromosome abnormality is identified it can prevent the dependence on other, sometimes quite costly, studies your physician might consider to investigate the cause of the miscarriage.

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

Chromosome testing could be especially very important to 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 for the miscarriages and invite their doctor to pursue other types of testing. For couples with multiple miscarriages determined to truly have a chromosomal cause, in vitro fertilization (IVF) with preimplantation genetic diagnosis (PGD) testing may be able to help increase their chances of having an effective healthy pregnancy. loss