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. In case you have suffered a pregnancy loss or are currently in the process of having a miscarriage, you could 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?
What type 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 common cause for first trimester miscarriage is 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 crucial that it have the right level of chromosome material; missing or extra material during conception or within an embryo or fetus can cause a woman 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 due to chromosome abnormalities. This number may be closer to 75% or more 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 upsurge in women older than 35.
Pregnancy Loss – How Common could it be?
Miscarriage is far more common than most people think. Up to one atlanta divorce attorneys 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 possess a healthy pregnancy rather than miscarry again. However, some women seem to be more prone 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 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 an unusual period. Another reason may be that more women are conceiving at older ages.
Types of Genetic Testing Helpful for Miscarriages
Genetic testing actually refers to many different types of testing that you can do on the DNA in a cell. For miscarriage tissue, also called products of conception (POC), probably the most useful type of test to perform is a chromosome analysis. A chromosome analysis (also called chromosome testing) can examine all 23 pairs of chromosomes for the presence of extra or missing chromosome material (aneuploidy). infant loss Because so many miscarriages are due to aneuploidy, chromosome analysis on the miscarriage tissue could identify the reason behind the pregnancy loss.
The most common approach to chromosome analysis is called 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 that reason requirement, tissue that’s passed at home is frequently unable to be tested with this 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 the mother (maternal cells) and cells from the fetus. If a normal female result is available, it may be the right result for the fetus or it can be maternal cell contamination (MCC) in which the result actually originates from testing the mother’s cells within the pregnancy tissue rather than 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; both most common types 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’re more prone to receive results and the results are typically returned faster when microarray testing is used. Additionally, some laboratories are collecting an example of the mother’s blood simultaneously 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 type of abnormality found could be assessed to help answer fully the question: “Will this happen to me again?”. More often than not, chromosome abnormalities within an embryo or fetus aren’t 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 loved ones that predisposes one to have miscarriages.
Furthermore, if a chromosome abnormality is identified it can prevent the need for other, sometimes quite costly, studies your doctor might consider to investigate the cause of the miscarriage.
Lastly, knowing the reason 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 can be especially very important to patients with repeated miscarriages, as it can 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 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 a successful healthy pregnancy.
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