反復流産に体外受精胚移植がおすすめ　

1999/5/27　ロイター　スペインの研究によると、流産を繰り返す原因の多くは染色体の異常によるものだから、体外受精をして得られた胚を調べて染色体の異常でない胚を移植すると成功しやすいとしている。

In vitro fertilization advised after repeat miscarriage

NEW YORK, May 27 (Reuters Health) -- In vitro fertilization (IVF) may allow many women with a history of recurrent miscarriage to achieve a successful pregnancy, according to a report in the June issue of the journal Fertility and Sterility.
In many of these cases, repeat miscarriage may be due to chromosomal abnormalities in the embryo, explain Dr. Antonio Pellicer and colleagues at the Universitat Autonoma de Barcelona, in Bellaterra, Spain. They speculate that IVF may allow for selection between ``several embryos, which increases the chance of having a normal embryo (implanted) in the uterus.''
The causes of repeat miscarriage remain unclear. Many experts believe the problem lies in abnormalities on one of more of the embryo's chromosomes -- cellular 'warehouses' for genetic material. These abnormalities can interfere with embryonic development, triggering miscarriage.
To test this theory, the investigators examined rates of chromosomal abnormalities in 66 miscarried embryos and compared them with abnormalities in embryos from 103 women unaffected by repeat miscarriage.
They report that ``the chromosomal status of embryos from patients with recurrent miscarriage is poorer than that of embryos from other patients.'' Overall, 50% to 80% of embryos miscarried during the first trimester had some form of chromosomal aberration.
According to the authors, IVF and pre-implantation genetic testing may help couples and their physician choose between candidate embryos, selecting the embryos that have the lowest likelihood of chromosomal defects. These embryos would then be implanted into the uterus in the hopes of achieving a successful pregnancy.
However, Pellicer's team points out that risks for embryonic chromosomal abnormality appear to rise with the increasing age of the mother. For this reason, they say, ``older patients (in this study, over 36 years of age) may not benefit from this technology.''
SOURCE: Fertility and Sterility 1999;71:1033-1039.