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Q. Will IVF help in avoiding chromosomal abnormality in future pregnancy?

Answered by
Dr. Sameer Kumar
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jan 03, 2020

Hello doctor,

I am 38 years old and my wife is 36 years old. We are married for the last two years and trying for a baby for the last one year almost.

By our gynecologist advise we underwent an IUI cycle which resulted in missed abortion at seven weeks due to no growth of fetus after five weeks.

D & C done and karyotype of abortion showed a chromosomal abnormality. Remarks as below:

Aborted fetus karyotype, 69, XXX G-banded metaphase shows triploidy.

Wife's condition:

a) Age: 36 years no issue yet.

b) Has a subserous uterus fibroid of size 68 x 62 mm and bulky uterus.

c) Had thyroid and she takes Thyroxin 50 mg every day. Last TSH is 1.48.

d) Sugar is under control and TBC is normal.

e) In childhood she had one occurrence of epilepsy.

Husband's condition:

a) Age: 38 years.

b) Nonsmoker and non-drinker.

c) semen analysis result is normal (normal fertile specimen).

d) Shaving a bit high uric acid in the last one year (under medicine).

Karyotyping results of partners:

Husband: 46, XY G banded metaphase shows normal karyotype.

Wife: 46, XX high frequency of G-banded metaphase shows telomeric association of chromosomes 1, 3, 16 & X.

My questions are is it possible that after fibroid removal she can conceive a baby in a normal way? Can there be any bad effect on baby's health (physical and mental) due to the DNA abnormality found in her report?

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Hello,

Welcome to icliniq.com.

1. As far as the subserous nature of the fibroid is concerned which is around 7cm x 6 cm, it per se is not going to have an effect or cause hindrance in conception but it is likely that it can cause problems during the pregnancy and in the late third trimester due to abdominal pain. So, it is advisable that it should be removed anyways as the size is a concern here and can cause incoordinate uterine contractions during labor later and also chances are that it would further grow under estrogen effect. Hence better get it removed.

2. As the fetus showed triploidy XXX G banded metaphase, which as per the mother's report, she has high chances of replication of similar results in future pregnancies as well which may not be compatible with life and likely missed abortions may occur in future. Hence, it is suggested that both of you should try for an IVF (in vitro fertilization) with ovum and sperm harvesting and in vitro fertilization of the egg by your sperm and subjecting the embryos to preimplantation genetic screening with FISH (fluorescence in situ hybridization) technique or PCR (polymerase chain reaction) or comparative genomic hybridization (CGH), before selecting the embryo for transplanting into the uterus.

Though the frequency of G banded metaphase telomeric association is high for 1, 3, 16 and X chromosome, the chances of the fetus getting triploidy are very high. Another best option for you as a couple would be to opt for a donor egg from another woman which can be fertilized in vitro by your sperm and then the embryo after pre implantation genetic screening can be implanted in your wife's womb to improve the chances of having a healthy conception.

I hope this helps.


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