Pregnancy loss and miscarriages can happen anytime during pregnancy. The risk of abortion is higher during the first trimester. This is estimated in the range of 10- 12% for spontaneous pregnancies while it could be up to 20-25% for IVF pregnancies. Endometrial evacuation and clearance of the uterine walls is essential for cases of 6 -7 weeks, of confirmed gestational age, by ultrasound. The excised embryonic tissue is sent to cytogenetics in order to rule out trisomy (the most frequent chromosomal abnormality usually found in 1st trimester). There is a 5% to 25% probability of a wrong answer because of the tissue destruction and mixture of the tissues. This is inevitable after curettage since embryo, placenta and endometrium are all one mass. The risk of a lab mistake increases once the embryo is female. Nowadays technology provides small telescopes of only 2.8mm, guided via cervical canal, providing excellent view and firm diagnosis of the abortion causes. The chorionic and amniotic membranes, the embryo, the umbilical cord, the yolk sac and the endometrial cavity are all meticulously examined, using the hysteron-embryoscopy technique. There is no pain during the procedure and the embryo can be collected and send to the cytogenetic lab using a small 5Fr grasper. Once the endometrial cavity examination is completed evaluation and curettage is performed. According to both international and our own scientific data of more than 500 cases of hysteroembryoscopy and cytogenetic analyses the following results have been reported.
-66% were diagnosed to have external and genetic abnormalities,
-14% reported normal genetic material but had abnormal external characteristics like missing a leg or an eye etc.
-6% had normal external characteristics but the genetic material was abnormal.
-14% had normal embryo, external and genetic characteristics. However endometrial pathologies, congenital uterine anomalies and defective implantation were evident in these cases.
– 5-7 % was not able to have a firm diagnosis of the abortion cause.
Hystero-embryoscopy is of vital importance since it can provide the reason of the miscarriage and consequently, measures and treatments can be taken to protect a future pregnancy. In addition the information on the cause of the abortion alleviates the emotional distress and answers patient’s questions.