ASRM ABSTRACTS: Two studies relating to recurrent miscarriage

This is one of a series of news items from abstracts of studies presented at the 2013 Annual Meeting of the American Society for Reproductive Medicine as complied by Dr. David Meldrum, former partner and Scientific Director of Reproductive Partners. We appreciate the enormous amount of work it takes

At ASRM 2013 two abstracts discuss studies to deal with the frustrating problem of recurrent miscarriage.

In women with a history of one to two losses, a randomized clinical controlled study showed that low dose aspirin decreased the time to pregnancy. Previous studies have found an increase in IVF success with low dose aspirin and one study found increased ovarian and uterine blood flow. Based on this abstract, empiric use of low dose aspirin in women with a history of miscarriage seems reasonable.

In another study, comprehensive chromosome screening was shown to be a cost-effective approach for recurrent pregnancy loss, even without including cost savings from avoiding miscarriages and by reducing the incidence of multiple births by employing single embryo transfer.

This is in contrast to previous thinking based on the facts that PGS done on a limited number of chromosomes on biopsies done on Day 3 did not improve live birth rates. That is because taking one cell from an eight cell embryo on Day 3 does not give an accurate picture of the predominant chromosomal pattern. That’s because there may be a number of different chromosomal configurations in a Day 3 embryo (mosaicism).

Now the biopsies are done on Day 5 and all chromosomes are checked. By day 5 much of the mosaicism corrects itself and being able to test all chromosomes leads to more accurate results. We can also biposy more than one cell of a now over-100 cell embryo.

RPMG offers IVF with PGS for recurrent pregnancy loss after a careful evaluation of possible other reasons for the repeated losses. For more information please see our page on PGS For Chromosomes.