Midline uterine defect size is correlated with miscarriage of euploid embryos in recurrent cases.

Abstract

OBJECTIVE:

To compare subsequent pregnancy outcomes after two or more miscarriages in patients with and without congenital uterine anomalies.

DESIGN:

Case-control study.

SETTING:

Nagoya City University Hospital.

PATIENT(S):

A total of 42 patients with a bicornuate or septate uterus and 1528 with normal uteri.

INTERVENTION(S):

No surgery.

MAIN OUTCOME MEASURE(S):

The cumulative success rate for birth, abnormal chromosome karyotype rate in aborted concepti, and the predictive values of the height of the defect/length of the remaining uterine cavity ratio (D/C ratio).

RESULT(S):

Of the total of 1676 patients, 54 (3.2%) had congenital uterine anomalies; 25 (59.5%) of the 42 patients with a bicornuate or septate uterus had a successful first pregnancy after examination, while this was the case for 1096 (71.7%) of the 1528 with normal uteri. There was no difference in the cumulative live-birth rate (78.0% and 85.5%) within the follow-up period. However, the rates for an abnormal chromosome karyotype in aborted concepti in cases with and without uterine anomalies were 15.4% (two of 13) and 57.5% (134 of 233), respectively, with the latter being significantly higher. The D/C ratio in the miscarriage group was also significantly greater than that for the live-birth group.

CONCLUSION(S):

Congenital uterine anomalies have a negative impact on reproductive outcome in couples with recurrent miscarriage and are associated with further miscarriage with a normal embryonic karyotype. The D/C ratio was found to have a predictive value for further miscarriages in recurrent cases.

• Authors: Mayumi Sugiura-Ogasawara, Yasuhiko Ozaki, Tamao Kitaori, Kyoko Kumagai, Sadao Suzuki
• Journal: Fertility and sterility (Fertil Steril) Vol. 93 Issue 6 Pg. 1983-8 (Apr 2010) ISSN: 1556-5653 [Electronic] United States
• PMID: 19249757 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Topics

• Aborted Fetus (metabolism, pathology)
• Abortion, Habitual (etiology, pathology)
• Adult
• Case-Control Studies
• Female
• Humans
• Infant, Newborn
• Organ Size (physiology)
• Parity
• Ploidies
• Pregnancy
• Pregnancy Outcome (epidemiology)
• Pregnancy Rate
• Uterine Diseases (complications, congenital, epidemiology, pathology)
• Uterus (abnormalities, pathology)