Human chromosome polymorphism and disordered reproductive function. I. Routine chromosome variants]

Routine polymorphic variants of chromosomes of 58 married couples with reproductive failure (two or more spontaneous abortions, stillbirths and malformed children) and 48 control couples, having two or more normal children and no spontaneous abortions and stillbirths, were investigated by conventional staining technique. Extreme variants of chromosomes 1, 9, 16, 17, 13--15, 21--22 and Y were found in 17.2% of subjects with reproductive loss and in 15.6% of control individuals. No significant differences in frequencies of scored routine variants were noted between married couples with reproductive failure and couples with normal reproduction.     

Balanced translocations among couples with two or more spontaneous abortions: Are males and females equally likely to be carriers?

Chromosome studies were performed on a series of 177 couples referred for genetic counseling following two or more spontaneous abortions to clarify the relationship between karyotype and fertility in males and females and to provide risk figures for genetic counseling. The results of these investigations, when combined with those in the literature, suggest that 2-3% of individuals in couples experiencing early fetal losses carry a balanced translocation and that this is not markedly influenced by the number of losses greater than two. Females are more likely than males to be the carrier, reflecting the fact that structural abnormalities of the chromosomes that are compatible with fertility in the female may be associated with sterility in the male. Karyotyping should be performed on both members of a couple following two spontaneous abortions and the products of conception should be studied whenever possible to begin to determine the biological basis of the association between parental rearrangement and fetal loss.     

Value of chromosome tests in genetic counseling of infertile couples

A cytogenetic analysis of more than 7000 subjects has been performed in the aetiological screening of infertile couples. This study revealed that infertile couples can be divided into three groups: those with one or more spontaneous abortions before 13 weeks of gestations, those with primary sterility (no gestation for at least 24 months) or those with secondary sterility (after one or more children, no further gestation for at least 24 months). The frequency of chromosomal abnormalities observed in this population is 2,9%, i.e. 1/17 couple. The results, according to sex of subjects bearing the chromosomal abnormality, were then analysed in each of the three groups. From this study, the authors insist on the advantage of systematically performing a chromosome analysis in the case of infertile couples for two main reasons: frequency of chromosomal abnormalities is relatively high in this population, detection of such abnormalities enables some couple to be rapidly directed to other solutions (Artificial Insemination), and others, due to prenatal chromosomal diagnosis, to have offspring in safety.     

High resolution cytogenetic evaluation of couples with recurring fetal wastage

Summary Both high resolution and routine chromosome analyses were used to study couples with a history of two or more spontaneous abortions in early pregnancy. In the 20 couples studied, two of the women were found to have an inversion. One paracentric inversion, (13)(q13.1q22.3), was apparent on routine analysis. The small pericentric inversion (11)(p11.12q12.3), was only detected by high resolution techniques. Given the low yield and increased cost and effort involved, we do not believe that high resolution studies are justified for screening couples with repeated abortions.     

Parental HLA compatibility, fetal wastage and neural tube defects: evidence for a T/t-like locus in humans

To test the hypothesis that a locus in or near the human major histocompatibility complex (HLA) contributes to both involuntary fetal loss and neural tube defects (NTD), we evaluated sharing of antigens of the HLA-A, HLA-B, or HLA-DR loci of couples who had three or more first-trimester spontaneous abortions or who had a child with an NTD (myelomeningocele or anencephaly). HLA-A antigen sharing was increased in couples with three or more spontaneous abortions and in couples who had an anencephalic fetus, when compared with couples who had three or more pregnancies and no fetal loss. Increased sharing of antigens at the HLA-A and B loci was not seen in the entire group of couples with children with myelomeningocele, but was found in the subgroup of 36 couples whose child had a lumbar myelomeningocele. An increase in HLA-DR sharing was not seen in any group or subgroup when compared with the control couples. Among the aborting couples, increased sharing was not restricted to the couples who had no term pregnancies, but was also found in the couples whose fetal losses occurred after one or more normal term pregnancies. These results are consistent with the hypothesis that a locus on the HLA-A side of the HLA-DR locus contributes to some fetal loss and susceptibility to NTD. This model is proposed as an alternative to the hypothesis that the maternal immune response to paternal major histocompatibility complex (MHC) antigens is the basis for increased HLA sharing in couples with fetal wastage.     

A cytogenetic study of repeated spontaneous abortions.

During a cytogenetic study of spontaneous abortions, successive abortions from 40 couples were karyotyped. The chromosome constitutions of the first and second abortions were found to be highly correlated. In each of 21 instances in which the first abortion was chromosomally normal, the subsequent abortion(s) was normal as well. In nine cases, the two abortions were chromosomally abnormal, and in four of these, both abortions were trisomic. Combined with findings from other studies of consecutive spontaneous abortions, the present data indicate that certain couples are at an increased risk for either repeated chromosomally normal abortions or for repeated trisomic conceptions. The increased risk of trisomy does not seem to be restricted to a particular chromosome, and the magnitude of the risk increase appears to be independent of maternal age.     

Chromosome studies in 2136 couples with spontaneous abortions

Summary Two thousand one hundred and thirty six couples with one or more spontaneous abortions (SAB) before 13 weeks of gestation and with or without one normal liveborn child (NLC) were karyotyped. In 4.31% of the couples one partner was a carrier of a major chromosomal abnormality. Couples with SAB only have 2-fold more chromosomal aberrations than couples with SAB and NLC. A correlation between the frequency of chromosomal abnormalities and the number of SAB was observed. Finally, the various types of chromosome aberrations were analysed.     

A new case of Y to X translocation in a female

Summary Cytogenetic investigation of married couples with the history of two or more recurrent abortions or unsuccessful pregnancies was carried out. The study concerns the occurrence of reciprocal translocations in regard to spontaneous miscarriages. In 115 examined couples 9 reciprocal translocations were observed, i.e., in 7.8%.     

罗伯逊易位分子机理初探

目的：探讨复发性自然流产与染色体罗伯逊易位间的关系。方法：采用人外周血淋巴细胞培养,常规G显带技术行染色体核型检查,并结合临床资料对其进行分析。结果：57对复发性自然流产夫妇中,检出罗伯逊易位染色体核型4例,检出率3.51%。结论：罗伯逊易位是导致复发性流产的重要原因之一,对复发性自然流产患者进行常规的染色体检查及遗传咨询具有一定的临床意义。     

A cytogenetic study of couples with recurrent spontaneous abortions and infertile patients with recurrent IVF/ICSI failure

PURPOSE:

This study was conducted to determine the frequency and contribution of chromosomal abnormalities in miscarriages and in couples with recurrent in vitro fertilization/intra cytoplasmic sperm injection (IVF/ICSI) failure.

MATERIALS and METHODS:

A total of 221 individuals; 79 with three or more recurrent spontaneous abortions and 142 with at least three IVF/ICSI failures. Chromosomal analysis from peripheral blood lymphocytes was performed according to standard cytogenetic methods using G-banding technique.

RESULTS:

Abnormal karyotype was found in 21 (9.50%) individuals. Of these 21 subjects, 4 (19.04%) exhibited sex chromosomal abnormalities and 17 (80.96%) had autosomal abnormalities. Male partners had significantly higher chromosomal abnormalities (5.88%) than of females (3.61%). These abnormalities were also higher in patients with recurrent spontaneous abortions than with IVF/ICSI failure (P < 0.05).

CONCLUSIONS:

These data may be indicative that chromosomal abnormalities are involved more in spontaneous abortions than in recurrent IVF/ICSI failure. Cytogenetic analysis could be valuable for these couples when clinical data fail to clarify the cause.     

Population genetics study of differential fertility in humans (based on an example of habitual abortion). III. Distribution of individual heterozygosity and genotype combinations for 9 polymorphic loci

Distribution of individual heterozygosity (the number of heterozygous loci per individual), wife/husband genetical differences and frequencies of genotypes formed by paired combination of eight polymorphic loci were studied in a group of couples and single women with repeated spontaneous abortions, and in a group of couples with normal fertility. No statistically significant differences were found for the first two parameters. Marked increase of genetical variability was shown for the women with repeated spontaneous abortions, as consequence of elevation of frequency of rare genotypic paired combinations. Therefore, differential fertility, as a component of stabilizing selection, alters the distribution of complex genotypes in human populations.     

Spontaneous abortions in hospital staff engaged in sterilising instruments with chemical agents.

Spontaneous abortions in hospital sterilising staff were analysed using data from a postal questionnaire and a hospital discharge register. The study included all the sterilising staff employed in Finnish hospitals in 1980; the controls were nursing auxiliaries. Data from the questionnaire showed that the frequency of spontaneous abortions was 11.3% for the sterilising staff and 10.6% for the nursing auxiliaries. When the staff were concerned in sterilising procedures during their pregnancy the frequency was 16.7% compared with 5.6% for the non-exposed pregnancies. Adjustment for age, parity, decade of pregnancy, smoking habits, and intake of coffee and alcohol did not affect the differences. The increased frequency of spontaneous abortion correlated with exposure to ethylene oxide but not with exposure to glutaraldehyde or to formaldehyde. Analysis of spontaneous abortions from the hospital discharge register confirmed the findings. Thus the results from the two independent analyses suggest that exposure to ethylene oxide in hospitals may carry a risk of spontaneous abortion among sterilising staff.     

Cell type-dependent difference in the distribution and frequency of excess thymidine-induced common fragile sites: T lymphocytes and skin fibroblasts

Summary Common fragile sites were induced by excess thymidine in phytohemagglutin-stimulated T lymphocytes from 4 normal individuals, and skin fibroblasts from 4 normal and 5 fra(X) positive individuals. The results indicate that the frequency and distribution of excess thymidine-induced fragile sites are different between these two types of cells. The sites at 1p13 and 2p11.2, induced in both types of cells, have not previously been described, and are thus considered to be excess thymidine-specific fragile sites. These findings extend and support our previous studies on cell type-dependent difference in aphidicolin-induced common fragile sites.     

Cytogenetic findings in 122 couples with recurrent abortions

Summary R-banded chromosome complements were analysed from 122 couples who had experienced three or more spontaneous abortions. Five women and one man were found to be carriers of translocations t(2;17), t(5;9), t(11;22), t(17;22), and t(13q14q). Two other karyotypes were abnormal: 46,XXq- and 47,XXX. Banded chromosome studies are recommended for couples with repeated abortions.     

Karyotyping results of the material of spontaneous abortions and miscarriages after using assisted reproductive technologies

The results of a molecular cytogenetic study of the material of spontaneous abortions and nonprogressive pregnancies in the first trimester in 43 couples who were treated with various ART methods are presented in this paper. Chromosomal pathologies (CPs) were present in 28 (65%) samples of chorionic villi. A comparative analysis of the frequency and types of CPs in groups composed according to the pathological states in the semen of males was performed. Recommendations to improve the efficiency of ART are developed based on the data.     

Cytogenetic survey in couples with recurrent fetal wastage

Summary Cytogenetic studies have been performed in 1068 couples with antecedent fetal wastage, i.e., at least two spontaneous first trimester abortions or one spontaneous first trimester abortion and one late fetal death, particularly with multiple congenital malformations.Three major types: 33 reciprocal translocations (3.09%), 20 Robertsonian translocations (1.87%) and six other chromosomal abnormalities (0.56%) were found, bringing the total number of chromosomal abnormalities to 59 (5.5%) in 1068 couples under investigation.In contrast to couples with reciprocal translocations, a high excess of female over male carriers was found in the group of Robertsonian translocations.In the evaluation of chromosomal polymorphisms, only variants with particularly large paracentromeric constitutive heterochromatin blocks were taken into account, and their low frequency in the present study is therefore not comparable with that in a general population.The impact of further extensive familial investigation on genetic counseling and the follow-up of prenatal diagnosis are discussed.     

Twinning rate in spontaneous abortions.

An unselected series of spontaneous abortions and their mothers were karyotyped with Q-bands to obtain a frequency of twin conceptions lost during the first trimester. Among 661 spontaneous abortions, 15 twin pairs were identified including two sets of conjoined twins. Analysis of Q-band variants permitted the exclusion of cases with two cell lines that could be attributed to maternal contamination or mosaicism. The twinning rate among spontaneous abortions was 1/44 compared with 1/103 live births and stillbirths in the Ontario population. If Weinberg's differential method is applied to these data, the frequency would be as high as 1/30 under the assumption that the incidence of monozygotic twins among abortions is the same as that for live births.     

Hla-Sharing, Recurrent Spontaneous Abortion, and the Genetic Hypothesis

A number of studies indicates that there is a high sharing of HLA antigens in couples having recurrent spontaneous abortions. The genetic hypothesis to explain this phenomenon suggests that this fetal loss results from homozygosity of recessive lethal or deleterious alleles in gametic disequilibrium with HLA antigens. Theory predicting the lethality rate is derived when antigens are shared at one, two or three loci, given that the disequilibrium is absolute. In addition, the effects of partial disequilibrium, inbreeding, and segregation distortion on the lethal proportion are examined.     

The Origin of Abnormalities in Recurrent Aneuploidy/Polyploidy

Recurrent miscarriage due to sporadic chromosomal abnormalities may simply be a consequence of the dramatic increase of trisomic conceptions with increased maternal age. However, it is also possible that some couples are at increased risk of abnormalities as a result of gonadal mosaicism, factors affecting chromosome structure and segregation, increased sperm aneuploidy in the male partner, or accelerated "aging" of the ovaries. We report cytogenetic and molecular findings from 122 spontaneous abortions (SAs) from 54 couples who were ascertained as having two or more documented aneuploid or polyploid SAs. The distribution of abnormalities in this group was similar to those from 307 SAs that involved chromosome abnormalities and were diagnosed at the same center but did not involve documented recurrent aneuploidy/polyploidy. Although recurrence of the same abnormality was observed in eight families, this number was equal to that expected by chance, indicating that gonadal mosaicism is rarely the explanation for recurrence. The origin of the abnormality was determined in 37 SAs from 23 of the couples in the study. A maternal meiotic origin was involved in 30 trisomies and in 1 triploid SA; 3 additional maternal trisomies were of possible somatic origin. A paternal origin was found in the remaining two trisomies and in one triploid SA. In addition, one double trisomy was the consequence of both a maternal and a paternal meiotic error. These results confirm that the etiology of trisomy is predominantly a result of meiotic errors related to increased maternal age, regardless of whether the couple has experienced one or multiple aneuploid SAs. Furthermore, this is true even when a second SA involves the same abnormality. Nonetheless, these data do not exclude some population variability in risk for aneuploidy.     

Population genetic study of differential fertility in man (illustrated by habitual abortion). IV. Distribution of blood groups and frequency of incompatible marriages

Hereditary variation of 5 immunological systems coded by 8 loci was compared in 148 couples and 100 women with repeated spontaneous abortions in anamnesis (experimental group) and 141 couples and 100 women with normal fertility (control group). Marked differences in distributions of genotypes and frequencies of 3 systems (MNSs, Rhesus, Duffy) and frequency of AB0-incompatible couples were found between control and experimental groups. An average value of observed heterozygosity in experimental group was lower, as compared to the expected value. Possible influence of immunological factors on recurrent fetal wastage is discussed.