Improved accuracy of hysteroembryoscopic biopsies for karyotyping early missed abortions

: ObjectiveTo assess the potential of direct embryo and chorion biopsies obtained by hysteroembryoscopy for karyotyping early missed abortions.: DesignClinical prospective descriptive study.: SettingInstituto Valenciano de Infertilidad, Valencia, Spain.: Patient(s)Sixty-eight women (71 gestational sacs) with missed abortions. The gestational age on ultrasound was 6.3 weeks (range, 4–10 weeks).: Intervention(s)Transcervical hysteroembryoscopy before curettage.: Main outcome measure(s)Comparison between the cytogenetic results from hysteroembryoscopic biospies and those of the curettage material.: Result(s)Hysteroembryoscopic biopsies could be taken in 97.2% of the gestational sacs. Direct embryo and chorion biopsies were suitable for chromosomal analysis. Selective samples identified misdiagnoses of the conventional curettage karyotype due to maternal contaminating tissues in 22.2% of the cases. Direct hysteroembryoscopic biopsies also enabled the diagnosis of a true placental mosaicism and the study of the individual karyotype of each gestational sac in bizygotic twin missed abortions.: Conclusion(s)In early missed abortions, karyotypes from direct hysteroembryoscopic biopsies were more accurate than those from the curettage material. The finding of a 46,XX karyotype in the curettage material is not a reliable result. [Copyright &y& Elsevier]