Is There a Role for Assisted Reproductive Technology in Recurrent Miscarriage?

Rosa Vissenberg; Mariëtte Goddijn

doi:10.1055/s-0031-1293208

Seminars in Reproductive Medicine, Table of Contents

Semin Reprod Med 2011; 29(6): 548-556
DOI: 10.1055/s-0031-1293208

Is There a Role for Assisted Reproductive Technology in Recurrent Miscarriage?

Rosa Vissenberg¹ , Mariëtte Goddijn¹

¹Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Academic Medical Center (Q3-119), University of Amsterdam, Amsterdam, The Netherlands

Abstract

ABSTRACT

Unexplained recurrent miscarriage (RM) is a significant health problem for which no effective treatment is available yet. In only 50% of couples with RM a cause can be found. In clinical practice, a frequently asked question is whether assisted reproductive technology (ART) is a treatment option. The scientific rationale and the chances of success for ART in couples with unexplained RM are still controversial. Presently, there is not enough evidence to justify IVF or intrauterine insemination (IUI) as a treatment option. Research on oocyte donation has been reported in one article. It is questionable whether couples with unexplained RM would undergo the potential risks and emotional aspects of ART. There is insufficient data on whether preimplantation genetic diagnosis improves the live birthrate in carriers of a structural chromosome rearrangement with a history of RM. No randomized controlled trials are available for preimplantation genetic screening (PGS) for unexplained RM. A recently published review concluded that the live birthrate for IVF/PGS and natural conception groups appears to be quite similar. Because evidence is lacking, we recommend refraining from ART in couples with recurrent miscarriage.

KEYWORDS

Recurrent miscarriage - assisted reproductive technology - preimplantation genetic screening - preimplantation genetic diagnosis - live birthrates

Full Text

References

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Mariëtte GoddijnM.D. Ph.D.

Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Academic Medical Center (Q3-119), University of Amsterdam

P.O. Box 22700, 1100 DE Amsterdam, The Netherlands

Email: m.goddijn@amc.uva.nl