Carrier couples have same chance of having healthy baby, despite miscarriages.(Clinical report)

COPENHAGEN -- The chances of having a healthy newborn are similar among patients with a history of recurrent miscarriage, regardless of whether they have chromosomal abnormalities, Maureen T.M. Franssen, M.D., reported during the annual meeting of the European Society of Human Reproduction and Embryology.

But carriers of chromosomal abnormalities have a higher risk of repeat miscarriage before eventually achieving their successful pregnancies.

Dr. Franssen of the Center for Reproductive Medicine, Academic Medical Center, Amsterdam, and her associates analyzed 705 couples who had experienced recurrent miscarriage and had been tested for chromosome abnormalities.

A total of 278 couples were identified as carriers, meaning that they had chromosome abnormalities. In carrier couples, products of conception can sometimes have an unbalanced karyotype, resulting in miscarriage, stillbirth, or the birth of a child with major congenital handicaps, she explained.

The study compared the reproductive outcomes of carrier couples with those of the 427 noncarrier couples (controls) over a mean follow-up period of 5.8 years.

A significantly greater percentage of the carrier couples than controls (16% vs. 6%) decided to stop trying to get pregnant. The main reason given by carriers was their risk of giving birth to a viable but unhealthy child. Among controls, the main reason was advanced maternal age.

Both groups had similar rates of successful reproductive outcomes, meaning the birth of a healthy child (83% for carriers and 84% for controls), but the carrier group had a significantly higher rate of miscarriage before a successful pregnancy (49% vs. 30%).