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The analysis of products of conception (POC) is clinically important to establish the cause of early pregnancy loss. Data from such analyses can lead to specific interventions in subsequent natural or assisted conceptions. The techniques available to examine the chromosomal composition of POC have limitations and can give misleading results when maternal cell contamination (MCC) is overlooked. The aim of this study was to develop a protocol for MCC assessment and to formulate POC material handling, testing, and reporting recommendations. Using array comparative genomic hybridization, we tested 86 POC samples, of which 47 sample pairs (DNA extracted from the POC sample and maternal DNA) were assessed for the presence of MCC. MCC was evaluated using an approach we developed, which exploited the genotyping of 14 STR, AMEL, and SRY loci. POC samples showing the clear presence of villi (63.9%) did not contain any signs of the maternal genome and can therefore be reliably tested using conventional methods. The proportion of 46,XX karyotype in the unselected sample batch was 0.39, which fell to 0.23 in visually good samples and was 0.27 in samples having no signs of contamination upon MCC testing. MCC assessment can rescue visually poor samples from being discarded or wrongly genotyped. We demonstrate here that classification based on visual POC material evaluation and MCC testing leads to predictable and reliable POC genetic testing outcomes. Our formulated recommendations covering POC material collection, transportation, primary and secondary processing, as well as the array of pertinent considerations discussed here, can be implemented by laboratories to improve their POC genetic testing practices. We anticipate our protocol for MCC assessment and recommendations will help reduce the misconception regarding the etiology of miscarried fetuses and foster informed decision-making by clinicians and patients dealing with early pregnancy loss. [ABSTRACT FROM AUTHOR]

Early pregnancy loss (EPL) is the most common complication of early pregnancy and has a negative impact on the couple’s reproductive experience, including depression and anxiety disorders. Embryo selection is one of the most important steps in achieving success of ART treatment. Selection of high implantation potency embryo can improve treatment outcome and decrease EPL and multiple pregnancy rate implementing selective single embryo transfer (SET). One of the noninvasive embryo selection methods is time-lapse based morphokinetic (TLM) evaluation of the embryonic development. So, the objective of the study was to compare EPL rate between conservative embryo cultivation/selection and TLM groups. Longitudinal cohort study of 376 couples undergoing ICSI cycles in private reproductology clinic iVF Riga was performed. Logistic regression analysis adjusted by age and autologous oocyte in TLM assessment and control group was done, so there were no statistically significant differences in biochemical, clinical and ongoing pregnancy rates per ET, but EPL rate per ET was still statistically significantly reduced: OR 0.41, 95%CI 0.17–0.98,p = 0.044. TLM embryo culturing and selection method is safe, reliable and noninvasive strategy for improvement ongoing pregnancy rate and decreasing EPL rates for patient undergoing infertility treatment. [ABSTRACT FROM PUBLISHER]