question about POC
3 Replies
celia m - October 17

Heelo, I had my 4th misscarriage this month. I just got the kayotype back on the poc, it was normal. On U/S it looked like a blighted ovum, isn't that always abnormal? We in the past have only tested the 2nd preg. it was trisomy 16. My hx should be at the bottom of the screen. What do you think? Also, my husband and I were tested and had normal karyotypes. Thank you


Dr Smith - October 20

The karyotype of the POC can be ambiguous if the results are 46XX, because maternal tissue often contaminates the specimen. So, if your results were 46XX and considered "normal", it may have been contamination. A "blighted ovum" is not always genetically abnormal in terms of the karyotype. It results from a blastocyst stage embryo with an inadequate number of stem cells. The karyotype may still be normal.

Clomid can cause the endometrium to be thin (by blocking the positive effect of estrogen) and therefore increase the chances of miscarriage. That can be misdiagnosed as a "luteal phase defect". My advice: give up on the Clomid and move on to controlled ovarian hyperstimulation with IUI. If your endometriosis has not been treated laparoscopically within the past 6 months, the lesions have probably reappeared and may also be contributing to you difficulties.


celia m - October 24

Thanks Dr. Smith. We gave up on Clomid in 2004. All of my pregnancies have been "on our own". I have not had the endo looked at since 2001, it was an incidental finding. We are thinking of IVF. Is it true that IVF "bypasses" endo? I have never had pain or any symptoms from the endo. Thank you


Dr Smith - October 25

No, IVF does not "bypass" endometriosis. Endometriosis can have a negative impact on egg quality (endometriomas) and embryo implantation (pelvic endometriosis). Endometriosis is also considered a system disease (i.e. affects the whole body) and can result in autoimmune problems such as elevated natural killer cells which, when elevated, can cause the body to reject the embryo. It doesn't matter if you are experiencing symptoms or not. If you have a history of endometriosis, its a good idea to address that before proceeding with ART treatment (IUI or IVF).



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