THE ROLE OF PREIMPLANTATION GENETIC DIAGNOSIS FOR RISK REDUCTION OF PREGNANCY LOSSES IN PATIENTS WITH BALANCED CHROMOSOME REARRANGEMENTS

Objective. To evaluate the risk of early pregnancy losses, including miscarriage, in patients with balanced chromosome rearrangements after different methods of fertilization. Materials and methods. The study enrolled couples after natural fertilization, after IVF without PGD, and also 109 couples after IVF with PGD. One spouse in the couple carried a balanced chromosome rearrangement. Relative risk (RR), odds ratio (OR) and their 95% confidence internals (CI) were calculated for pregnancy losses. PGD embryos screening for chromosomal abnormalities was done by using fluorescence in situ hybridization (FISH). Results. Thefrequency of early pregnancy losses was 23,1% (3 in 13 pregnancies) in couples after IVF with PGD, in couples after natural fertilization — 61,4% (108 in 176 pregnancies), and in couples after IVF/ICSI without PGD — 68,4% (13 in 19 pregnancies), (р 1=0,009; р 2=0,029). RR was 2,7 times higher for pregnancy loss in group after natural fertilization compared to group after PGD. Odds ratio for pregnancy loss after IVF-ET (in vitro fertilization and embryo transfer) without PGD was 7,22 compared higher compared to group after IVF with PGD. Conclusion. Using IVF with PGD in patients with balanced chromosome rearrangements leads to risk reduction of miscarriage compared to couples after natural fertilization. The IVF with PDG is recommended for couples with recurrent miscarriage and where one partner carries a balanced chromosome rearrangement.

preimplantation genetic diagnosis, balanced chromosome rearrangements, relative riskfor miscarriage, odds ratio for miscarriage