Evaluating the link between chromosomal abnormalities and diminished ovarian reserve, mode of conception, and history of prior miscarriages in cases of early missed abortion using CNV-seq
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Abstract Objective: This study was developed as a retrospective analysis of the rates of embryonic chromosomal abnormalities in cases of missed miscarriages during early pregnancy, with a focus on identifying associated factors as a means of clarifying the genetic basis for missed miscarriages and how this pregnancy outcome relates to a variety of clinical and demographic characteristics. Methods : The present study enrolled 1490 patients who had been diagnosed with missed miscarriage and underwent CNV-seq testing at the Jiangxi Maternal and Child Health Hospital from January 2020 through December 2022. Medical records were accessed to obtain clinical data pertaining to these miscarriage cases, and the results of chromosomal abnormality testing were analyzed. Results: Chromosomal abnormalities were detected in 63.76% of all missed miscarriages, and included instances of autosomal trisomy (68.38%), triploidy/polyploidy (11.68%), 45XO (10.84%), CNVs (8.84%), double/multiple trisomy (4.32%), sex chromosome trisomy/polyploidy (0.32%), and complex abnormalities (2.95%). An examination of the relationship between these chromosomal abnormalities and clinical characteristics revealed that chromosomal abnormality incidence rates were significantly related to maternal age, mode of conception, AMH levels, and the presence or absence of an embryonic/fetal heartbeat. Advanced maternal age, mode of conception, and lower AMH levels were associated with a greater risk of embryonic chromosomal abnormalities. Specifically, the rates of autosomal trisomy gradually rose with maternal age (P<0.05), whereas 45XO, CNVs, and triploidy/polyploidy detection rates declined with age (P<0.05). Declining ovarian reserve function was associated with higher rates of karyotypic abnormalities (P<0.05). Higher rates of karyotypic abnormalities were also evident in the natural conception (NC) group, as were rates of CNVs and trisomy/polyploidy (P < 0.01), whereas higher rates of autosomal trisomy were detected in the assisted reproductive technology (ART) group. No relationship between a history of spontaneous miscarriages and the incidence of embryonic chromosomal abnormalities was detected. Conclusion: Embryonic chromosomal abnormalities are the leading cause of early missed miscarriages. The present results indicate that advanced maternal age, declining ovarian reserve function, and mode of conception can all increase the risk of these chromosomal abnormalities. Age and the presence of a fetal/embryonic heartbeat may be related to the incidence of different types of chromosomal abnormalities, while a history of prior missed miscarriages is not related to the odds of embryonic chromosomal abnormalities.
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Evaluating the link between chromosomal abnormalities and diminished ovarian reserve, mode of conception, and history of prior miscarriages in cases of early missed abortion using CNV-seq | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluating the link between chromosomal abnormalities and diminished ovarian reserve, mode of conception, and history of prior miscarriages in cases of early missed abortion using CNV-seq Shuhui Huang, Xiaoqing Chen, Danping Liu, Huizheng Yuan, Yongyi Zou, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4641482/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 09 Dec, 2025 Read the published version in BMC Pregnancy and Childbirth → Version 1 posted 12 You are reading this latest preprint version Abstract Objective: This study was developed as a retrospective analysis of the rates of embryonic chromosomal abnormalities in cases of missed miscarriages during early pregnancy, with a focus on identifying associated factors as a means of clarifying the genetic basis for missed miscarriages and how this pregnancy outcome relates to a variety of clinical and demographic characteristics. Methods : The present study enrolled 1490 patients who had been diagnosed with missed miscarriage and underwent CNV-seq testing at the Jiangxi Maternal and Child Health Hospital from January 2020 through December 2022. Medical records were accessed to obtain clinical data pertaining to these miscarriage cases, and the results of chromosomal abnormality testing were analyzed. Results: Chromosomal abnormalities were detected in 63.76% of all missed miscarriages, and included instances of autosomal trisomy (68.38%), triploidy/polyploidy (11.68%), 45XO (10.84%), CNVs (8.84%), double/multiple trisomy (4.32%), sex chromosome trisomy/polyploidy (0.32%), and complex abnormalities (2.95%). An examination of the relationship between these chromosomal abnormalities and clinical characteristics revealed that chromosomal abnormality incidence rates were significantly related to maternal age, mode of conception, AMH levels, and the presence or absence of an embryonic/fetal heartbeat. Advanced maternal age, mode of conception, and lower AMH levels were associated with a greater risk of embryonic chromosomal abnormalities. Specifically, the rates of autosomal trisomy gradually rose with maternal age (P<0.05), whereas 45XO, CNVs, and triploidy/polyploidy detection rates declined with age (P<0.05). Declining ovarian reserve function was associated with higher rates of karyotypic abnormalities (P<0.05). Higher rates of karyotypic abnormalities were also evident in the natural conception (NC) group, as were rates of CNVs and trisomy/polyploidy (P < 0.01), whereas higher rates of autosomal trisomy were detected in the assisted reproductive technology (ART) group. No relationship between a history of spontaneous miscarriages and the incidence of embryonic chromosomal abnormalities was detected. Conclusion: Embryonic chromosomal abnormalities are the leading cause of early missed miscarriages. The present results indicate that advanced maternal age, declining ovarian reserve function, and mode of conception can all increase the risk of these chromosomal abnormalities. Age and the presence of a fetal/embryonic heartbeat may be related to the incidence of different types of chromosomal abnormalities, while a history of prior missed miscarriages is not related to the odds of embryonic chromosomal abnormalities. missed abortion CNV-seq Chromosome abnormality Maternal age Pregnancy mode；AMH；Embryonic/fetal size Number of abortions； Figures Figure 1 Introduction Spontaneous abortion refers to cases of pregnancy termination without any external intervention prior to a gestational age of 28 weeks when the fetal weight is under 1000 g. This outcome affects an estimated 10-15% of all clinical pregnancies, with over 95% of cases of spontaneous abortion occurring before a gestational age of 12 weeks [1] . Missed abortion (MA) cases are a subset of spontaneous abortions in which the fetus or embryo remains within the uterus after death, failing to undergo natural expulsion in a timely manner [2] . Many different contributing factors have been linked to MA incidence, including embryonic chromosomal abnormalities, infections, lifestyle factors, parental chromosomal abnormalities, immune activity, endocrine functions, thrombotic disorders, reproductive organ abnormalities, and environmental factors [3] . Strikingly, embryonic chromosomal abnormalities are estimated to account for more than 50-60% of all cases of spontaneous abortion [4-5] . More advanced maternal age is a key risk factor associated with a greater frequency of embryonic chromosome number abnormalities due to changes in recombination activity with age [6-7] . The degree to which other factors including gestational age, ovarian function, mode of conception, and history of prior miscarriages influence the risk of chromosomal abnormalities, however, remains incompletely understood. As published evidence remains contradictory, a retrospective cohort study was herein performed to explore the associations between chromosomal abnormalities and clinical findings in cases of early MAs, including maternal age, ovarian reserve function, the size of the embryo/fetus at the time of abortion, history of prior natural miscarriages/ MAs /biochemical pregnancies , and the use of assisted reproductive technology (ART). The goal of these analyses was to clarify the correlative links between these clinical characteristics and the incidence or characteristics of chromosomal abnormalities in cases of early MA. Materials and Methods 1.1 Data sources This was a retrospective analysis of patients diagnosed with MA who had undergone uterine curettage and low-depth high-throughput whole-genome copy number variation sequencing (CNV-seq) testing at Jiangxi Maternal and Child Health Hospital between June 2020 and December 2022. All testing was performed after receiving written informed consent from patients, with the results being included in this study. MA was diagnosed based on the guidelines for ultrasound-based diagnosis established in 2013 by the American Institute of Ultrasound in Medicine [8] : ① a history of missed menstruation, blood HCG results, or ultrasound confirmation of pregnancy; crown-rump length (CRL) < 45 mm or biparietal diameter < 20 mm, approximately equivalent to a gestational age of less 12 weeks; ② CRL ≥ 7 mm with no heartbeat; ③ Average gestational sac diameter ≥ 25mm, with no embryo; ④ No embryonic heartbeat detected in the gestational sac without a yolk sac after two weeks; ⑤ No embryonic heartbeat detected 11 days after yolk sac detection; and ⑥ No history of infection or toxic compound exposure while pregnant. Patients were excluded if they exhibited biochemical pregnancies, ectopic pregnancies, molar pregnancies, twin/multiple pregnancies, had undergone preimplantation genetic testing (PGS), or had incomplete data. 1.2 Data collection and grouping Cases exhibiting karyotypic abnormalities were classified as follows: numerical abnormalities (trisomy, monosomy, sex chromosome trisomy, sex chromosome monosomy, triploidy/polyploidy, double/multiple trisomy), structural abnormalities (chromosomal microdeletion/microduplication), and complex abnormalities (both numerical and structural abnormalities). Clinical records were accessed to retrospectively obtain miscarriage-related clinical data, including maternal age, history of natural miscarriages before 12 weeks of pregnancy, ultrasound-based measurements of fetal size at the time of diagnosis, the presence of fetal heartbeat, embryo, and yolk sac, whether anti-Müllerian hormone (AMH) testing had been performed within the past year, and whether the pregnancy was the result of an ART procedure. Patient subgroup classifications were made as follows: ① Maternal age at the time of miscarriage: <25 years, 25-29 years, 30-34 years, 35-39 years, or ≥ 40 years. ② Ultrasound examination results at the time of miscarriage were used to classify patients based on embryo/fetus size as follows: intrauterine fluid darkness (empty sac), yolk sac visible without embryo, embryo visible without cardiac activity, and cessation of cardiac activity after visible cardiac activity. ③ AMH levels: < 1.1 ng/ml, 1.1-4.5 ng/ml, or ≥ 4.5 ng/ml. ④ Pregnancy method: ART or natural conception (NC). ⑤ Number of previous natural miscarriages/MAs/biochemical pregnancies before 12 weeks: 0, 1, 2, or ≥ 3 times. The Medical Ethics Committee of Jiangxi Maternal and Child Health Hospital approved this study (Ethical Approval No: (EC-KY-202011). 1.3 Sample Collection Ultrasound examinations were performed for all patients after the confirmation of pregnancy, and the diagnosis of MA was confirmed. Chorionic villus samples were aseptically collected from these patients after outpatient surgery. A minimum of 10 mg of chorionic villus tissue per patient was collected with sterile forceps, rinsed with physiological saline, and transferred into a sterile specimen bag for storage at 2-8°C. 1.4 Experimental approach ① DNA Extraction: Samples were warmed to room temperature, minced, ground, combined with a digestion solution, mixed thoroughly, and centrifuged for 5 min at 2,000. The supernatant was removed, and a QIAamp DNA Blood Mini Kit (Catalog No.: 51106) was used to extract DNA as directed. ② CNV-seq analysis: An Agilent 2100 Bioanalyzer was used to assess nucleic acid integrity, while a Nanodrop was used to evaluate the concentration and purity of FNA. Following end repair, adapter ligation adapter-ligated product purification, PCR amplification, and amplicon purification, quantitative analyses were performed. Then, nucleic acid nanoballs were prepared, Qubit quality control was performed, and the BGIseq-500 platform was used for sequencing at a 5 Mb resolution. Sequencing data were aligned to the GRCh37/hg19 reference genome. The American College of Medical Genetics and Genomics guidelines were used for annotation and interpretation. This approach allows for the detection of chromosomal aneuploidy and segmental deletions/duplications exceeding 100 Kb. 1.5 Statistical analyses SPSS 23.0 was used to analyze all data. Data are reported as frequencies and percentages, and were analyzed with chi-square or Fisher’s exact tests as appropriate. P < 0.05 was the threshold for significance. Results 2.1 Characterization of chromosomal abnormalities associated with early MAs In total, this study included 1490 cases, with a mean age of 31.07 ± 4.9 years (18-49 years), a mean gravidity of 2.29±1.43 (1-11), and a mean parity of 0.35±0.62 (0-4). For details regarding the clinical characteristics of these patients, see Table 1. In the analyzed samples, 540 and 950 cases with normal chromosomes and pathogenic chromosomal abnormalities were detected. The cases with chromosomal abnormalities accounted for 63.76% of all cases, and included 838 cases (88.21%) of numerical abnormalities, 84 (8.84%) of pathogenic Copy number variations(CNVs), and 28 (2.95%) of complex abnormalities. In addition, 118 cases of mosaicism were observed. As no detailed cytogenetic analyses were performed, these mosaicism cases were included in the groups with numerical abnormalities and CNVs. This study only included pathogenic CNVs, whereas benign CNVs or those of unknown significance were not included. Of the detected chromosomal abnormalities, instances of single autosomal trisomy (n=573, 68.38%) were the most common, followed by triploidy/polyploidy (n=111, 11.68%), 45XO (n=103, 10.84%), and double/multiple trisomy (n=41, 4.32%). In addition, 3 cases (0.32%) of sex chromosome trisomy/polyploidy were detected, including 1 instance of 46,XXX, 1 of 47,XXX mosaic duplication (mosaicism ratio: 55%), and 1 of 49,XXXXY. Of the single autosomal trisomies detected in this analysis, trisomies 16 and 22 were the most common, with 160 (16.85%) and 102 (10.74%) respective cases. Trisomy 21 was detected in 42 cases (4.42%), trisomy 15 was detected in 39 cases (4.11%), and trisomy 13 was detected in 37 cases (3.89%). There were no instances of trisomy 19, and trisomy 1 was only detected in a single case of mosaic duplication (mosaicism ratio: 19%) (see Table 2 and Figure 1). Table 1: The clinical characteristics of missed abortion cases with available cytogenic results (n=1490) Maternal age（years） 31.07±4.9 ＜25 （n%） 113(7.58) 25-29（n%） 489(32.82) 30-34（n%） 546(36.64) 35-39（n%） 256(17.18) ≥40（n%） 86(5.77) gravidity（n） 2.29±1.43 Parity（n） 0.35±0.62 Number of prior missed abortion at ＜12 weeks（n） 1490 None（n%） 924(62.01) One（n%） 370(24.83) Two（n%） 140(9.40) Three or more（n%） 56(3.76) Mode ofconception 1490 NC（n%） 1145(76.85) ART（n%） 345(23.15) Ovarian reserve a 700 ＜1.1ng/ml（n%） 87(12.43) 1.1-4.5ng/ml（n%） 389(55.57) ≥4.5ng/ml（n%） 224(32.00) Ultrasound prompts fetal size(total) 1490 Empty sac（n%） 258(17.32) See yolk sac（n%） 298(20.22) See germ without fetal heart（n%） 382(25.64) Stop after seeing fetal heart rate（n%） 552(37.05) Continuous variables are shown as the mean (standard deviation). Categorical variables are shown as n (%). a The total number of cases was 700. Complex abnormalities were defined as those involving both chromosome number and structural abnormalities. 2.2 Chromosomal Abnormality Distributions as a Function of Gestational Age Given the potential for delayed ovulation or the delayed diagnosis of miscarriage, ultrasound results were used to classify miscarriages before 12 weeks into four categories: empty yolk sac, visible yolk sac, embryo visible without cardiac activity, and cessation of cardiac activity after visible cardiac activity. Chromosomal abnormalities in these four respective groups were observed in 123 cases (47.67%), 192 cases (64.63%), 265 cases (69.37%), and 370 cases (67.03%). The lowest rate of chromosomal abnormality detection was observed in the empty sac group, and the detection rate rose significantly following the appearance of the yolk sac (χ2=36.71, P<0.01). Trisomy was most frequently detected in the group with a visible embryo but no cardiac activity (χ2=85.225, P<0.01), while 45XO was most frequently detected abnormality in the group in which cardiac activity had ceased after detection of a fetal heartbeat (χ2=103.101, P<0.01), and CNVs were most commonly detected in the empty sac group (χ2=86.441, P<0.01). Double/multiple trisomy was most frequently detected in the group with a visible yolk sac (χ2=13.88, P<0.01), whereas higher triploidy/polyploidy detection rates were observed in the empty sac group and the group in which cardiac activity had ceased after detection of a fetal heartbeat (χ2=76.21, P<0.01) (Table 3). 2.3 Chromosomal Abnormality Distributions as a Function of Maternal Age Among cases with a maternal age of < 25 years, 25-29 years, 30-34 years, 35-39 years, and ≥ 40 years, chromosomal abnormalities were respectively detected in 74 (65.49%), 304 (62.17%), 332 (60.81%), 171 (66.80%), and 69 (80.23%) cases. The lowest detection rate was observed for maternal ages from 25-34, whereas a significant increase in these rates was observed among women aged ≥40 years (χ2=67.122, P<0.01). Trisomy detection rates rose gradually with age, including a sharp increase after 35 years of age (χ2=58.551, P<0.01). The rates of CNVs and 45XO detection, in contrast, were highest when the maternal age was < 25 years and gradually declined with increasing age (χ2=24.708, P<0.01; χ2=11.488, P<0.05). Triploidy/polyploid detection rates were higher among individuals < 34 years of age, declining sharply above the age of 35 (χ2=20.21, P0.05). No significant differences in the detection rates of other types of chromosomal abnormalities were observed across these age groups (P>0.05) (see Table 3). 2.4 Chromosomal Abnormality Distributions as a Function of Ovarian Reserve Of these 1,490 cases, AMH testing had been performed within the last 12 months in 700 cases. Patients were classified based on AMH levels into three groups: < 1.1 ng/ml, 1.1-4.5 ng/ml, and ≥ 4.5 ng/ml. Chromosomal abnormalities were detected in 62 (71.26%), 234 (60.15%), and 123 (54.91%) of cases in these groups, respectively, with detection rates increasing significantly as AMH levels declined (χ2=7.007, P<0.05). When analyzing the distributions of chromosomal abnormality types across these three respective groups, trisomy rates were found to rise whereas triploidy/polyploidy detection rates declined significantly (74.19% vs. 66.67% vs. 56.10%, χ2=6.826, P<0.05; 8.06% vs. 8.55% vs. 17.07%, χ2=6.629, P0.05). As age is independently associated with the risk of chromosomal abnormalities, an age-based stratified analysis was conducted. When stratifying according to age, chromosomal abnormalities were detected in these three respective ovarian reserve groups among patients ≥35 years old in 38 (77.55%), 76 (66.09%), and 20 (80.00%) cases, whereas among patients <35 years old they were detected in 24 (63.16%), 158 (57.66%), and 103 (51.76%) cases, respectively. A higher but non-significant increase in chromosomal abnormality detection rate was observed in the low ovarian reserve group (< 1 ng/mL) for both patients 0.05). No significant differences in chromosomal abnormality distributions were observed among other groups when stratifying cases based on age (P>0.05) (Table 4). 2.5 Distribution of Chromosomal Abnormalities as a Function of the Mode of Conception When these 1,490 cases were classified into ART and NC groups according to the mode of conception, chromosomal abnormalities were detected in 189 (54.78%) and 761 (66.46%) cases, with a significantly lower detection rate in the ART group relative to the NC group (χ2=175.977, P<0.05). When cases were stratified according to age, chromosomal abnormalities were detected in 84 and 156 cases in the ART and NC subgroups, respectively, among patients with a maternal age ≥ 35 years, while among patients < 35 years of age they were detected in 105 and 605 cases in these two respective groups. A significant reduction in the rate of chromosomal abnormalities was detected in the ART group among patients < 35 years old (65.19% vs. 47.73%, χ2=22.993, P0.05). Relative to the NC group, the ART group exhibited significantly increased rates of trisomy (57.56% vs. 71.43%, χ2 = 12.432, P<0.05), whereas the corresponding rates of CNVs and triploidy/polyploidy detection decreased (9.86% vs. 4.76%, χ2=10.561, P<0.05; 13.01% vs. 6.35%, χ2=10.561, P<0.05). Following age-based stratification, the ART group exhibited a significantly lower rate of triploidy/polyploidy detection relative to the NC group among patients < 35 years of age (15.37% vs. 8.57%, χ2=18.17, P<0.05), while a non-significant increase in the trisomy detection rate was observed in both the ≥ 35 and 0.05; 73.72% vs. 84.52%, χ2=3.656, P>0.05). No significant differences were observed for the comparisons among any other groups (P>0.05) (Table 5). 2.6 Associations Between Numbers of MAs and Chromosomal Abnormalities Study subjects were separated into four groups based on whether they had experienced 0, 1, 2, or ≥ 3 prior instances of natural miscarriage/MA/biochemical pregnancy. Chromosomal abnormalities were detected in 589 (64.16%), 240 (64.00%), 88 (62.4%), and 33 (58.93%) cases in these respective groups. As the number of prior miscarriages rose, the abnormal karyotype detection rate declined, albeit non-significantly (P>0.05). No differences in chromosomal abnormality detection rates were observed when stratifying patients based on whether they were 0.05). Chromosomal abnormality type distributions were analyzed across groups, revealing no significant differences in these distributions among groups (see Table 5). Table 3: Associations between chromosomal abnormality detection rates, fetal size, and maternal age Ultrasound prompts fetal size Patient age（years） Empty capsule See yolk sac See germ without fetal heart Stop after seeing fetal heart rate P ＜25 25-29 30-34 35-40 ≥40 P Normal 135（52.33） 106（35.57） 117（30.63） 182（32.97） 39（34.51） 185（37.83） 214（39.19） 85（33.20） 17（19.77） Chromosome abnormality （n/%） 123(47.67) 192(64.63) 265(69.37） 370（67.03） <0.01 74（65.49） 304（62.17） 332（60.81） 171(66.80） 69（80.23） <0.01 Autosomal trisomy（n/%） 49(39.84) 133(69.27) 209(78.87) 18(49.19) <0.01 31（41.89） 154（50.66） 202（60.84） 127 (74.27） 59（85.51） <0.01 Autosomal haploid（n/%） 1(0.81) 1(0.52) 3(1.13) (0.54) ＞0.05 0（0.00） 3(0.99） 3（0.90） 1(0.58） 0（0.00） ＞0.05 Sex chromosome trisomy/polytomy（n/%） 0(0.00) 0(0.00) 0(0.00) (0.81) ＞0.05 0（0.00） 0（0.00） 1(0.00) 2(1.17) 0(0.00) ＞0.05 Monosomy X （n/%） 8(6.50) 2(1.04) 6(2.26) 8(23.51) <0.01 17(22.97) 43(14.14) 34(10.24) 8（4.68） 1（1.45） <0.01 Double/multiple trisomy（n/%） 7(5.69) 16(8.33) 10(3.77) 8(2.16) <0.01 1(1.35) 15(4.93) 12(3.61) 8(4.68) 5(7.25) ＞0.05 Triploidy/Polyploidy（n/%） 15(12.20) 16(8.33) 20(7.55) 60(16.22) <0.01 10(13.51) 45(14.80) 47(14.16) 8(4.68) 1(1.45) <0.01 Microdeletion and Microdupliction（n/%） 37（30.08） 20（10.42） 9（3.40） 18（4.86） <0.01 12（16.22） 32（10.53） 26（7.83） 13(7.60） 1（1.45） <0.05 Complex abnormality （n/%） 6（4.88） 4（2.08） 8(3.02) 10(2.70) ＞0.05 3（4.05） 12（3.95） 7（2.11） 4 (2.34） 2（2.90） ＞0.05 Table 4: Relationships between chromosomal abnormality detection rates and AMH levels Ovarian reserve AMH ＜ 1.10 AMH1.10-4.5 AMH ＞ 4.5 x2 P Normal total 25（28.74） 155（39.85） 101（45.09） ＜35 14（36.84） 116（42.34） 96（48.24） ≥35 11（22.45） 39（33.91） 5（20.00） Chromosome abnormality （n/%） total 62（71.26） 234（60.15） 123（54.91） 7.007 <0.05 ＜35 24（63.16） 158（57.66） 103（51.76） 2.537 ＞0.05 ≥35 38（77.55） 76（66.09） 20（80.00） 3.345 ＞0.05 Autosomal trisomy（n/%） total 46（74.19） 156（66.67） 69（56.10） 6.826 <0.05 ＜35 13（54.17） 90（56.96） 55（53.40） 0.338 ＞0.05 ≥35 33（86.84） 66（86.84） 14（70.00） 3.652 ＞0.05 Autosomal haploid（n/%） total 1 0 0 ＞0.05 ＜35 0 0 0 ＞0.05 ≥35 1 0 0 ＞0.05 Sex chromosome trisomy/polytomy（n/%） total 0 0 1 ＞0.05 ＜35 0 0 0 ＞0.05 ≥35 0 0 1 ＞0.05 Monosomy X （n/%） total 2（3.23） 23（9.83） 14（11.38） 4.034 ＞0.05 ＜35 1（4.17） 23（14.56） 14（13.59） 1.956 ＞0.05 ≥35 1（2.63） 0（0.00） 1（5.00） 3.16 ＞0.05 Double/multiple trisomy（n/%） total 2（3.23） 8（3.42） 3（2.44） 0.316 ＞0.05 ＜35 1（4.17） 6（3.80） 2（1.94） 0.789 ＞0.05 ≥35 1（2.63） 2（2.63） 1（5.00） 0.285 ＞0.05 Triploidy/Polyploidy（n/%） total 5（8.06） 20（8.55） 21（17.07） 6.629 <0.05 ＜35 4（16.67） 18（11.39） 19（18.45） 2.63 ＞0.05 ≥35 1（2.63） 2（2.63） 2（10.00） 2.572 ＞0.05 Microdeletion and Microdupliction（n/%） total 4（6.45） 21（8.97） 11（8.94） 0.425 ＞0.05 ＜35 3（12.50） 16（10.13） 9（8.74） 0.347 ＞0.05 ≥35 1（2.63） 5（6.58） 2（10.00） 1.383 ＞0.05 Complex abnormality （n/%） total 2（3.23） 6（2.56） 4（3.25） 0.439 ＞0.05 ＜35 2（8.33） 5（3.16） 4（3.88） 111.526 <0.05 ≥35 0（0.00） 1（1.32） 0（0.00） 0.769 ＞0.05 Table 5: Relationships between chromosomal abnormality detection rates, mode of conception, and history of prior MAs Mode of conception Number of prior missed abortion at ＜12 weeks Assisted reproductive technology Natural conception P 0 1 2 ≥3 P Normal total 156(45.22) 384(33.54) ＞0.05 329（35.61） 133（35.95） 55（39.29） 23（41.07） ＞0.05 ＜35 115(52.27) 323(34.81) ＞0.05 275（38.35） 110（37.16） 41（38.32） 12（42.86） ＞0.05 ≥35 41(32.80) 61(28.11) ＞0.05 54（26.09） 23（31.08） 14（42.42） 11（39.29） ＞0.05 Chromosome abnormality （n/%） total 189(54.78) 761（66.46） <0.01 595（64.39） 237（64.05） 859(60.71) 33(58.93) ＞0.05 ＜35 105(47.73) 605（65.19） <0.01 442(61.65） 186（62.84） 66(61.68) 16(57.14) ＞0.05 ≥35 84(67.20) 156（71.89） ＞0.05 153（73.91） 51(68.92) 19(57.58) 17(60.71) ＞0.05 Autosomal trisomy（n/%） total 135(71.43) 438（57.56） <0.01 370（62.18） 136(57.38) 43(50.59) 24 (72.73) ＞0.05 ＜35 64(60.95) 323（53.39） ＞0.05 252(57.01) 95 (51.08) 30(45.45) 10(62.5) ＞0.05 ≥35 71(84.52) 115（73.72） ＞0.05 118（77.12） 41(80.39) 13(68.42) 14(82.35) ＞0.05 Autosomal haploid（n/%） total 1(0.53) 6（0.79） ＞0.05 6（1.01） 0（0.00） 1（1.18） 0（0.00） ＞0.05 ＜35 0(0.00) 6（0.99） ＞0.05 5（1.13） 0（0.00） 1（1.52） 0（0.00） ＞0.05 ≥35 1(1.19) 0（0.00） ＞0.05 1（0.65） 0（0.00） 0（0.00） 0（0.00） ＞0.05 Sex chromosome trisomy/polytomy（n/%） total 0（0.00） 3（0.26） ＞0.05 2（0.34） 0（0.00） 1（1.18） 0（0.00） ＞0.05 ＜35 0（0.00） 1（0.00） ＞0.05 0（0.00） 0（0.00） 0（0.00） 0（0.00） ＞0.05 ≥35 0（0.00） 2（1.28） ＞0.05 1（0.65） 0（0.00） 1（5.26） 0（0.00） ＞0.05 Monosomy X （n/%） total 16（8.47） 87（11.43） ＞0.05 59（9.92） 32（13.50） 10（11.76） 2（6.06） ＞0.05 ＜35 13（12.38） 81（13.39） ＞0.05 52（11.76） 30（16.13） 10（15.15） 2（12.50） ＞0.05 ≥35 3（3.57） 6（3.85） ＞0.05 7（4.58） 2（3.92） 0（0.00） 0（0.00） ＞0.05 Double/multiple trisomy（n/%） total 9（4.76） 32（4.20） ＞0.05 22（3.70） 11（4.64） 7（8.24） 1（3.03） ＞0.05 ＜35 6（5.71） 22（3.64） ＞0.05 15（3.39） 9 （4.84） 4（6.06） 0 （0.00） ＞0.05 ≥35 3（3.57） 10（6.41） ＞0.05 7（4.58） 2（3.92） 3（15.79） 1（5.88） ＞0.05 Triploidy/Polyploidy（n/%） total 12（6.35） 99（13.01） <0.01 67（11.26） 33（13.92） 9（10.59） 2（6.06） ＞0.05 ＜35 9（8.57） 9（15.37） <0.01 62（14.03） 30（16.13） 9（13.64） 2（12.50） ＞0.05 ≥35 3（3.57） 6（3.85） ＞0.05 6（3.92） 3（5.88） 0（0.00） 0（0.00） ＞0.05 Microdeletion and Microdupliction（n/%） total 9（4.76） 75（9.86） <0.01 50（8.40） 18 （7.59） 12（14.12） 4（12.12） ＞0.05 ＜35 7（6.67） 63（10.41） ＞0.05 41（9.28） 17（9.14） 10（15.15） 2（12.50） ＞0.05 ≥35 2（2.38） 12（7.69） ＞0.05 9（5.88） 1（1.96） 2（10.53） 2（11.76） ＞0.05 Complex abnormality （n/%） total 7（3.70） 21（2.76） ＞0.05 19（3.19） 7（2.95） 2（2.35） 0 （0.00） ＞0.05 ＜35 6（5.71） 16（2.64） ＞0.05 15（3.39） 5（2.69） 2（3.03） 0（0.00） ＞0.05 ≥35 1（1.19） 5（3.21） ＞0.05 4（2.61） 2（3.92） 0（0.00） 0（0.00） ＞0.05 Discussion Chromosomal integrity is vital to embryo survival, with chromosomal abnormalities typically resulting in spontaneous abortion or intrauterine fetal demise. Analyses of embryo chromosomal status in cases of early MA can provide insight into the causes of miscarriage. Conventional chromosome G-banding techniques have historically been used for the karyotyping of miscarriage products. This strategy, however, is only capable of detecting certain chromosomal abnormalities and it is subject to limitations including the need for extended cell culture, susceptibility to contamination with maternal cells, poor microscopic resolution, and high rates of failure. Molecular genetic techniques have recently emerged as strategies that can overcome the limitations of chromosomal karyotyping in the clinic. Low-depth high-throughput whole-genome CNV-seq strategies can effectively detect chromosomal structural abnormalities, including microdeletions and microduplications under 100 kb in size. CNV-seq is also inexpensive, easy to implement, and rapid such that it is widely used for the chromosomal characterization of miscarriage products. Here, cases that had undergone CNV-seq analyses were retrospectively evaluated to characterize chromosomal abnormalities in cases of MA and to explore correlations between these abnormalities and patient clinical data. 3.1 Chromosomal Abnormality Distribution Frequencies Over 50% of MAs result from chromosomal abnormalities, with previous studies estimating anywhere from 50-70% of MAs to be associated with these abnormalities [9-11] . Variations in these rates may be the result of gestational age, the detection techniques employed, and other variables. Here, 950 of the analyzed cases (63.76%) were found to harbor karyotypic abnormalities, with chromosomal aneuploidy being the most common finding [12] . Chromosomal aneuploidy is the most prevalent cause of MA or intrauterine fetal demise. These abnormalities entail the absence or presence of particular chromosomes owing to errors that arise during the first round of meiotic division giving rise to an egg cell [13] . Autosomal trisomy is the most common finding in cases of early MA, with trisomies 13, 16, 18, 21, and 22 being particularly frequent [14] , followed by X monosomy and polyploidy [9,10] . For instance, one prior survey of 1,030 products of conception from MAs following single-embryo transfer detected aneuploidy in 80.6% of cases, of which 62.3% were trisomies, 7.8% were double trisomies, 0.5% were triploid or tetraploid, 1.3% exhibited 21-monosomy, 3.2% exhibited X-monosomy, 0.1% exhibited 47,XXY, 1.0% exhibited polyploidy, 1.0% presented with mixed abnormalities, 1.1% exhibited embryonic chimerism, and 2.4% exhibited structural abnormalities [15] . A separate cytogenetic analysis of embryos from 1,011 cases of early pregnancy loss revealed chromosomal abnormalities in 711 cases (70.3%) [16] . The most commonly reported abnormalities in these cases included autosomal trisomies (64.6%), triploidy (13.1%), and X monosomy (10.4%). In the present cohort, the most frequently detected abnormalities included trisomy 16 (16.85%), 45XO (10.84%), trisomy 22 (10.74%), trisomy 21 (4.42%), trisomy 15 (4.11%), and trisomy 13 (3.89%), in line with these past results. Triploidy/polyploidy was the second most frequent abnormality in this cohort (11.68%), including two cases of sex chromosome trisomy (one each of 47,XXX and 47,XXX with chimeric duplication and a chimerism ratio of 55%). X tetraploidy was also observed in one case (49,XXXXY). There were no instances of trisomy 19, while trisomy 1 was only detected in a single case of chimeric duplication (chimerism ratio: 19%). Chromosome 19 exhibits the highest gene density in the human genome, whereas the greatest number of genes is encoded on chromosome 1. Trisomy 19 or 1 may thus be lethal at an early stage of embryogenesis. 3.2 Chromosomal Abnormalities and Gestational Age There have been multiple past reports indicating that the detection rates and types of cytogenetic abnormalities in cases of early MA before 12 weeks gestation vary markedly as a function of embryo/fetus size, emphasizing the important roles that particular chromosomal factors play during the early phases of embryonic/fetal development [17] . The yolk sac precedes pregnancy, and its absence is indicative of a blighted ovum, most often as a consequence of poor embryonic development and premature demise. The embryo develops early during fetal development, with the pulsation of the primitive heart tube being the first indicator of fetal cardiac development. The yolk sac tends to appear around week 5 of pregnancy, with the embryo and fetal heart first manifesting at approximately weeks 6-7. The frequencies of embryo and fetal heart rate detection have been reported to be higher in cases of viable trisomies, X monosomy, and triploid miscarriages as compared to cases of karyotypic normality or miscarriages with other karyotypic abnormalities [18] . A CRL of less than 15 mm is most commonly associated with other forms of trisomy or structural trisomy in 57.7% and 11.5% of cases, respectively, whereas a CRL ≥ 15 mm is instead associated with instances of monosomy (38.7%), triploidy (29%), and viable trisomy (12.9%) [19] . Postmortem embryo pole length also reportedly varies significantly across karyotype groups, with the longest lengths in cases of trisomy 21, X monosomy, and triploidy at 16, 15.3, and 11.6 mm, respectively [20] . Here, the lowest rate of chromosomal abnormality detection was evident in the group in which the yolk sac was empty, whereas this rate rose significantly after yolk sac detection. Trisomies were most often detected in the yolk sac and embryo groups, whereas their detection rates were comparatively lower in the groups exhibiting an empty sac or cardiac pulsation. The 45XO detection rate was highest in the group with cardiac pulsation, supporting the differing developmental potentials of embryos harboring particular chromosomal abnormalities, with trisomy being related to embryogenesis and fetal heart development [15] . Certain forms of trisomy, including trisomy 16, are potentially associated with early embryonic development [20] , whereas 45XO appears to have no effect on the early stages of embryo growth. Nobuaki et al [17 ] observed no variations in triploidy or chromosomal structural abnormality frequencies as a function of gestational age. Igher embryonic development rates have been reported for cases of triploidy, X monosomy, and trisomy 21 as compared to other karyotypic findings [19] . Segawa et al [15] posited that double trisomy and triploidy events are significantly more common when no fetal heartbeat is detected, and that higher karyotypic abnormality rates are related to blighted ovum [21] . In the present study, the distributions of double/multiple trisomies, triploidy, and CNVs varied as a function of gestational age. The highest rate of double/multiple trisomy detection was evident in the yolk sac group, whereas triploidy was most commonly detected in the empty sac and cardiac pulsation groups. CNVs were more common in the empty sac group, suggesting that while triploidy/multiploidy are more likely to result in very early or later miscarriage, CNVs are linked to higher odds of very early miscarriage. The proportion of karyotypic abnormalities in the very early MA group with an empty yolk sac was relatively low, whereas the abnormality detection rate rose after the yolk sac was evident. This supports the important role of non-genetic factors including infections, immune activity, clotting, and other environmental factors in very early pregnancy failure [12] . 3.3 Chromosomal Abnormalities as a Function of Maternal Age and Ovarian Reserve Primary oocytes develop from primordial germ cells at ~3 months of fetal development and enter into dormancy for decades after undergoing meiosis I and genetic recombination, only resuming meiosis I and entering metaphase II prior to ovulation. Errors that impact chromosomal segregation can occur at each stage of meiosis and become more common as maternal age rises [22] . Chromosomal aneuploidies in human gametes and pre-implantation embryos are a common cause of pregnancy failure or infertility. Aneuploidy impacts an estimated 20% of human oocytes, and this number rises exponentially from ages 30-35, reaching 80% as of age 42 [7] . Indeed, maternal age is firmly established as a factor that is closely associated with chromosomal aneuploidy [23] . Here, patients were grouped according to maternal age in 5-year intervals, revealing that rates of chromosomal abnormalities were lowest among women ages 25-34 (62.17%, 60.81%), whereas these rates rose with age to a peak of 80.23% for women ≥40 years of age. The chromosomal abnormality detection rate began increasing significantly from age 30 to 34, raising the question of whether ovary aging begins to manifest at 30. However, an analysis of the types of chromosomal abnormalities associated with these different age groups revealed that trisomy detection rates began rising from age 35-40 (74.85%) to even higher levels after age 40 (85.51%). In contrast, 45XO detection rates peaked in cases where the mother was < 25 years old (22.97%), gradually declining with age to 10.24% at 30-34 and further declining in the 35-40 age group. Women 35+ years of age thus face higher odds of trisomy [12,24] , whereas 45XO is more common under the age of 35. Ozawa et al [17] also previously found that chromosomal abnormality rates for trophoblasts were higher for older (≥35 years) as compared to younger (< 35 years) women (70.59% vs. 51.48%), with autosomal trisomy rates rising with age, particularly in the case of trisomy 15 and 21. Rates of 45XO and CNV detection also declined with maternal age, while triploidy/multiploidy was more commonly detected among patients <34 years, declining sharply at ages above 35. Double/multiple trisomy rates also rose with age, thus supporting a model in which CNVs, sex chromosome abnormalities, and triploidy/multiploidy are more likely to impact women at a younger age, whereas double/multiple trisomies have greater odds of manifesting in women ≥35 years of age [12,17] . These differences may be attributable to the dynamics of chromosomal recombination, which tends to decline with age, resulting in a reduction in chromosomal segregation [25] . While maternal age is known to be closely associated with recombination rate, the corresponding effects of paternal age are less clear. This distinction is related to the sex-specific meiotic duration, timing, and outcomes [26] . Triploidy is a consequence of improper ploidy at the time of fertilization, which can arise from fertilization by two sperm or two eggs [27] . Sex chromosome monosomies are generally the result of the loss of the paternal X or Y chromosome, and they also present with a reverse age effect. One study previously demonstrated that the X chromosome source is related to maternal age, such that the average maternal age in the 45,XP group with a single X chromosome from the paternal side was significantly lower than that in the 45,Xm group with a single X chromosome from the maternal side [28] . Despite the strong evidence that advanced maternal age is related to the occurrence of trisomies and other chromosomal abnormalities and its status as an independent risk factor associated with miscarriage, the mechanistic basis for this relationship remains unclear. Ovarian reserve and function trend downward with age. To determine whether these changes may be associated with embryonic chromosomal abnormalities, correlations with ovarian reserve were thus examined at length. Serum AMH levels are positively correlated with ovarian reactivity in women of various ages [29] , and both age and levels of AMH are related to miscarriage risk [30] . Clinical pregnancy rates and live birth rates for women with higher AMH levels tend to be lower, with a corresponding rise in the rate of miscarriage [31] . AMH levels were thus leveraged as an index for ovarian reserve function in this study [32] . When specifically focusing on patients who had undergone AMH testing within the past year, a decrease in ovarian reserve function was found to be associated with a gradual rise in the rate of chromosomal abnormality detection. Given the independent association between age and chromosomal abnormalities, age-stratified analyses were performed, revealing that the chromosomal abnormality detection rate continued to rise with declining ovarian reserve function among both younger and older women. CNV, 45XO, and triploidy/multiploidy detection became less frequent with declining ovarian reserve, whereas the opposite was true for trisomy detection. These trends aligned well with age-related trends, further supporting a link between reduced ovarian reserve function and the incidence of chromosomal abnormalities. Shahine et al. [33] found that relative to patients with normal ovarian reserve function who experienced unexplained recurrent spontaneous abortion (RSA), those with declining ovarian reserve function who experienced RSA exhibited higher rates of embryonic aneuploidy. In this study, A higher proportion of aneuploid chromosomes was observed among women exhibiting declining ovarian reserve function (57% vs. 49%), with this difference having been most pronounced among women < 38 years of age (67% vs. 53%). The present study aligns well with these prior results. Limitations of these analyses include the smaller sample size, the fact that ovarian reserve function was only assessed using a single index, and the absence of any corresponding analyses of paternal age, however. Shahine [33] suggested that, compared to unexplained recurrent spontaneous abortion (RSA) patients with normal ovarian reserve function, unexplained RSA patients with declining ovarian reserve function have a higher incidence of aneuploid chromosomal abnormalities in embryos. Women with declining ovarian reserve function have a higher proportion of aneuploid chromosomes (57% vs. 49%), and this difference is more significant in patients under 38 years of age (67% vs. 53%). Our study aligns with the findings of Shahine's research. The limitations of this study include a small sample size, the need for further analysis with a larger sample, the use of a single indicator for assessing ovarian reserve function, and the lack of analysis of paternal age. 3.4 The Relationship Between Chromosomal Abnormalities and ART How ART relates to the incidence of embryonic chromosomal abnormalities has been a matter of some controversy. In some reports, ART was found to have no effect on such abnormalities [34-35] , although others have described higher rates of chromosomal structural abnormalities for patients undergoing ART (13.2% vs. 4.2%, P < 0.05) [10] . With respect to the types of embryo transfer protocols employed, chromosomal abnormality rates are reportedly lower in cases of frozen embryo or frozen blastocyst transfer [36] . Deletions and microdeletions are reportedly more common in cases of intracytoplasmic sperm injection (ICSI) as compared to in vitro fertilization and embryo transfer(IVF-ET) protocols. The utilization of frozen embryos has been suggested to help protect developing embryos from the adverse effects of exposure to an estrogen-rich environment [10] . Some studies, however, have argued that ART can contribute to a greater risk of embryo chromosomal abnormalities and miscarriage [37] . While the general types of chromosomal abnormalities in cases of ART may be similar to those for natural conception [9] , particular ART techniques also have the potential to preferentially give rise to certain abnormalities. ICSI, for instance, is linked to a greater risk of non-disjunction abnormalities, higher X monosomy rates [38] , and lower polyploidy rates [39] . Kim et al. [40] reported that aside from a higher rate of sex chromosome abnormalities among patients undergoing ICSI in cases of male factor infertility, ART was not linked to any greater odds of chromosomal abnormalities. The differences that do exist also have the potential to be a consequence of parental factors, rather than any risks unique to the procedure of ICSI itself. Here, a higher rate of trisomy detection was observed in the ART group, whereas CNV and triploidy/multiploidy detection rates were higher in the NC group. These trends remained intact when stratified according to age, supporting a link between ART and changes in the incidence of trisomies. ART has been reported to increase the risk of chromosomal numerical abnormalities, particularly in cases of trisomies [9] . One limitation of these analyses is that no effort was made to distinguish between different ART protocols when assessing chromosomal abnormality rates, underscoring a need for further studies aimed at clarifying the relationships between ART and these outcomes in order to guide the development of more optimal ART strategies. 3.5 The Link Between Prior Natural Miscarriages and Chromosomal Abnormalities Recurrent spontaneous abortion(RSA) is a term used to refer to instances of two or more miscarriages. More than half of women experience at least one miscarriage in their lifetime, and this proportion rises among women 35+ years of age, but < 1% of women experience three consecutive natural miscarriages [41] . These recurrent miscarriages can be physically and emotionally taxing for couples such that efforts to improve pregnancy outcomes for RSA patients are desperately needed. Efforts to clarify the etiological basis for RSA are vital for the appropriate evaluation and targeted treatment of pregnancies for couples with a history of RSA. Embryonic chromosomal abnormalities are in 64.8% of all cases of spontaneous abortion, whereas these abnormalities are only evident in 3.9% of unnaturally aborted embryos [9] . An estimated 76.2% of patients first found to exhibit embryonic chromosomal abnormalities have subsequent embryos with abnormal chromosomes [42] . A history of prior miscarriages may be linked to greater odds of embryonic chromosomal abnormalities [9] , owing either to abnormalities in the sperm or eggs themselves or to the effects of external environmental factors during the early stages of pregnancy [43-44] . As these same factors are also relevant across multiple pregnancies, any previous diagnoses of embryo karyotypic abnormalities are considered indicative of a greater risk of subsequent miscarriage [45] . Embryogenetic testing is thus often recommended in cases of retained miscarriages in order to provide more information for future pregnancies. Some studies, however, contradict this and indicate that a history of prior miscarriage is not linked to greater odds of detecting embryonic chromosomal abnormalities. One meta-analysis of 55 studies published since 2000 reported no differences in embryonic chromosomal abnormality rates when comparing sporadic and recurrent miscarriages (46%, 95% CI: 39-53 vs. 46%, 95% CI: 39-52) [46] . However, significantly higher rates of sex chromosome and structural abnormalities are evident in cases of sporadic miscarriage relative to recurrent miscarriage [10, 12] . As the number of miscarriages increases, some studies have suggested that the odds of chromosomal abnormalities decrease such that they are detected less frequently in cases of RSA [47] . Indeed, women with a history of ≥ 2 miscarriages exhibit significantly lower rates of chromosomal abnormalities relative to those with a history of < 2 miscarriages, and viable trisomy seemed to be the main contributor to this trend [17] . Here, no significant increase in the frequency of embryonic chromosomal abnormalities was detected as a function of the number of prior miscarriages, nor were there any significant differences in abnormal chromosomal distributions across these groups. Miscarriages typically occur in cases where both parents have normal chromosomes. However, in instances where both spouses exhibit chromosomal abnormalities as in the case of balanced translocations and Robertsonian translocations, carriers often appear phenotypically normal and have the potential for reproduction. As chromosomal imbalance affects 50-70% of the gametes and embryos in these cases, this contributes to a greater risk of embryonic chromosomal abnormalities and miscarriages. Couples who suffer a MA in China often seek out peripheral blood chromosomal testing at the hospital. When this leads to the detection of chromosomal abnormalities, some opt for preimplantation genetic testing (PGT), which can provide an avenue to obtain karyotypically normal healthy embryos prior to implantation, contributing to better pregnancy outcomes. Conclusion Embryonic chromosomal abnormalities are the leading cause of MAs during the early stages of pregnancy. The present results regarding the types and detection rates for different chromosomal abnormalities in cases of MA are in line with other large-scale studies. The developmental potentials of embryos differed based on their karyotype, with the lowest rates of abnormal chromosome detection having been observed in the empty sac group, supporting a limited role for genetic factors in very early miscarriages. It is thus important to emphasize the roles that other factors play in pregnancy loss. The risk of chromosomal abnormalities may also rise as a function of maternal age, the mode of conception, and declining ovarian reserve. Advanced age, in particular, is associated with a high risk of embryonic chromosomal abnormalities, particularly instances of autosomal trisomy, while CNVs, 45XO, and triploidy/polyploidy may manifest more frequently with younger maternal age. Declining ovarian reserve coincides with higher rates of detection for chromosomal abnormalities, and the distribution of types of abnormalities as a function of ovarian reserve is similar to the observed age-related distribution. Older women and those with declining ovarian reserve may thus benefit from PGT and prenatal diagnostic analyses. The higher rate of autosomal trisomy in the ART group also emphasizes the need to be attentive to the safety of ART for offspring. Abbreviations AMH anti-Müllerian hormone ART assisted reproductive technology CNVs Copy number variations CNV-seq copy number variation sequencing ICSI intracytoplasmic sperm injection IVF-ET in vitro fertilization and embryo transfer MA Missed abortion NC natural conception PGS Preimplantation Genetic Screening PGT preimplantation genetic testing RSA Recurrent spontaneous abortion Declarations Acknowledgements The authors wish to thank the participants, Jiangxi Maternal and Child Health Hospital hospital staf, and whoever contributed to this study. Authors’ contributions Conception/design: Shuhui Huang. Provision of study material or patients: Shuhui Huang;Danping Liu; Yongyi Zou Collection and/or assembly of data: Shuhui Huang, Xiaoqing Chen; Huizhen Yuan Data analysis and interpretation: Shuhui Huang, Baitao Zeng; Manuscript writing: Shuhui Huang; Manuscript revision: Guiqin Bai. Final approval of manuscript: All authors. Funding This work is supported by grants from the Science and technology support plan of Health commission of jiangxi province(Nos.220210887), The funder, Shuhui Huang was responsible for the article. Availability of data and material All data that support the fndings of this study were available from the cor‑responding author via E-mail due to appropriate request. Ethics approval and consent to participate Due to the retrospective nature of the study, informed consent was waived, but this study was granted by the Medical Ethics Committee of Jiangxi Maternal and Child Health Hospital and the ethics approval number was EC-KY-202011. 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Cytogenetic analysis of the retained products of conception after missed abortion following blastocyst transfer: a retrospective, large-scale, single-centre study. Reprod Biomed Online. 2017;34(2):203-210. doi:10.1016/j.rbmo.2016.11.005. Soler A, Morales C, Mademont-Soler I, et al. Overview of Chromosome Abnormalities in First Trimester Miscarriages: A Series of 1,011 Consecutive Chorionic Villi Sample Karyotypes. Cytogenet Genome Res. 2017;152(2):81-89. doi:10.1159/000477707 Ozawa N, Ogawa K, Sasaki A, Mitsui M, Wada S, Sago H. Maternal age, history of miscarriage, and embryonic/fetal size are associated with cytogenetic results of spontaneous early miscarriages. J Assist Reprod Genet. 2019;36(4):749-757. doi:10.1007/s10815-019-01415-y. Liu Y, Liu Y, Chen H, Du T, Tan J, Zhang J. The frequencies of the presence of embryonic pole and cardiac activity in early miscarriages with abnormal karyotypes. Clin Exp Obstet Gynecol. 2015;42(4):490-494.. Liu Y, Liu Y, Chen H, et al. Relationship of karyotype to embryo crown-rump length and maternal serum human chorionic gonadotropin level in early miscarriage. Am J Perinatol. 2015;32(1):15-22. doi:10.1055/s-0034-1371708. Ouyang Y, Tan Y, Yi Y, et al. Correlation between chromosomal distribution and embryonic findings on ultrasound in early pregnancy loss after IVF-embryo transfer. Hum Reprod. 2016;31(10):2212-2218. doi:10.1093/humrep/dew201. Goldstein SR, Kerenyi T, Scher J, Papp C. Correlation between karyotype and ultrasound findings in patients with failed early pregnancy. Ultrasound Obstet Gynecol. 1996;8(5):314-317. doi:10.1046/j.1469-0705.1996.08050314.x Hassold T, Hunt P. Maternal age and chromosomally abnormal pregnancies: what we know and what we wish we knew. Curr Opin Pediatr. 2009;21(6):703-708. doi:10.1097/MOP.0b013e328332c6ab Dai R, Li L, Zhu H, Geng D, Deng S, Liu R. Effect of maternal age on spontaneous abortion during the first trimester in Northeast China. J Matern Fetal Neonatal Med. 2018;31(14):1824-1829. doi:10.1080/14767058.2017.1330330. Fan L, Wu J, Wu Y, et al. Analysis of Chromosomal Copy Number in First-Trimester Pregnancy Loss Using Next-Generation Sequencing. Front Genet. 2020;11:545856. Published 2020 Oct 20. doi:10.3389/fgene.2020.545856. Henderson SA, Edwards RG. Chiasma frequency and maternal age in mammals. Nature. 1968;218(5136):22-28. doi:10.1038/218022a0. Hussin J, Roy-Gagnon MH, Gendron R, Andelfinger G, Awadalla P. Age-dependent recombination rates in human pedigrees. PLoS Genet. 2011;7(9):e1002251. doi:10.1371/journal.pgen.1002251. Marton T, Hargitai B, Patkós P, Csapó Z, Szende B, Papp Z. A fetopathologiai feldolgozás gyakorlata [Practice of fetal pathological examination]. Orv Hetil. 1999;140(25):1411-1416.. Hassold T, Benham F, Leppert M. Cytogenetic and molecular analysis of sex-chromosome monosomy. Am J Hum Genet. 1988;42(4):534-541. Ferraretti AP, La Marca A, Fauser BC, et al. ESHRE consensus on the definition of 'poor response' to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011;26(7):1616-1624. doi:10.1093/humrep/der092. Zhang B, Meng Y, Jiang X, et al. IVF outcomes of women with discrepancies between age and serum anti-Müllerian hormone levels. Reprod Biol Endocrinol. 2019;17(1):58. Published 2019 Jul 16. doi:10.1186/s12958-019-0498-3. Duncan FE, Jasti S, Paulson A, Kelsh JM, Fegley B, Gerton JL. Age-associated dysregulation of protein metabolism in the mammalian oocyte. Aging Cell. 2017;16(6):1381-1393. doi:10.1111/acel.12676. Dewailly D, Laven J. AMH as the primary marker for fertility. Eur J Endocrinol. 2019;181(6):D45-D51. doi:10.1530/EJE-19-0373. Shahine LK, Marshall L, Lamb JD, Hickok LR. Higher rates of aneuploidy in blastocysts and higher risk of no embryo transfer in recurrent pregnancy loss patients with diminished ovarian reserve undergoing in vitro fertilization. Fertil Steril. 2016;106(5):1124-1128. doi:10.1016/j.fertnstert.2016.06.016. Pylyp LY, Spynenko LO, Verhoglyad NV, Mishenko AO, Mykytenko DO, Zukin VD. Chromosomal abnormalities in products of conception of first-trimester miscarriages detected by conventional cytogenetic analysis: a review of 1000 cases. J Assist Reprod Genet. 2018;35(2):265-271. doi:10.1007/s10815-017-1069-1. Li G, Jin H, Niu W, et al. Effect of assisted reproductive technology on the molecular karyotype of missed abortion tissues. Biosci Rep. 2018;38(5):BSR20180605. Published 2018 Oct 17. doi:10.1042/BSR20180605. Li J, Zhang F, Sun B, et al. Lower chromosomal abnormality frequencies in miscarried conceptuses from frozen blastocyst transfers in ART. Hum Reprod. 2021;36(4):1146-1156. doi:10.1093/humrep/deaa352. Campos-Galindo I, García-Herrero S, Martínez-Conejero JA, Ferro J, Simón C, Rubio C. Molecular analysis of products of conception obtained by hysteroembryoscopy from infertile couples. J Assist Reprod Genet. 2015;32(5):839-848. doi:10.1007/s10815-015-0460-z. Lathi RB, Milki AA. Rate of aneuploidy in miscarriages following in vitro fertilization and intracytoplasmic sperm injection. Fertil Steril. 2004;81(5):1270-1272. doi:10.1016/j.fertnstert.2003.09.065. Martínez MC, Méndez C, Ferro J, Nicolás M, Serra V, Landeras J. Cytogenetic analysis of early nonviable pregnancies after assisted reproduction treatment. Fertil Steril. 2010;93(1):289-292. doi:10.1016/j.fertnstert.2009.07.989. Kim JW, Lee WS, Yoon TK, et al. Chromosomal abnormalities in spontaneous abortion after assisted reproductive treatment. BMC Med Genet. 2010;11:153. Published 2010 Nov 3. doi:10.1186/1471-2350-11-153. Branch DW, Gibson M, Silver RM. Clinical practice. Recurrent miscarriage. N Engl J Med. 2010;363(18):1740-1747. doi:10.1056/NEJMcp1005330. Sugiura-Ogasawara M, Ozaki Y, Katano K, Suzumori N, Kitaori T, Mizutani E. Abnormal embryonic karyotype is the most frequent cause of recurrent miscarriage. Hum Reprod. 2012;27(8):2297-2303. doi:10.1093/humrep/des179. Shen JD, Sun FX, Qu DY, et al. Zhonghua Fu Chan Ke Za Zhi. 2019;54(12):797-802. doi:10.3760/cma.j.issn.0529-567x.2019.12.002. Wang W, Shao S, Chen W, et al. Electrofusion Stimulation Is an Independent Factor of Chromosome Abnormality in Mice Oocytes Reconstructed via Spindle Transfer. Front Endocrinol (Lausanne). 2021;12:705837. Published 2021 Jul 28. doi:10.3389/fendo.2021.705837 van den Berg MM, van Maarle MC, van Wely M, Goddijn M. Genetics of early miscarriage. Biochim Biophys Acta. 2012;1822(12):1951-1959. doi:10.1016/j.bbadis.2012.07.001. Smits MAJ, van Maarle M, Hamer G, Mastenbroek S, Goddijn M, van Wely M. Cytogenetic testing of pregnancy loss tissue: a meta-analysis. Reprod Biomed Online. 2020;40(6):867-879. doi:10.1016/j.rbmo.2020.02.001． Sakamoto A, Kamada Y, Kubo K, et al. Slow Fetal Heart Rate before Miscarriage in the Early First Trimester Predicts Fetal Aneuploidy in Women with Recurrent Pregnancy Loss. Acta Med Okayama. 2018;72(1):61-66. doi:10.18926/AMO/55664. Table Table 2 is not available with this version Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 09 Dec, 2025 Read the published version in BMC Pregnancy and Childbirth → Version 1 posted Editorial decision: Revision requested 17 Jun, 2025 Reviews received at journal 11 Jun, 2025 Reviewers agreed at journal 29 May, 2025 Reviews received at journal 12 May, 2025 Reviewers agreed at journal 02 May, 2025 Reviews received at journal 16 Sep, 2024 Reviewers agreed at journal 03 Sep, 2024 Reviewers invited by journal 14 Aug, 2024 Editor invited by journal 28 Jun, 2024 Editor assigned by journal 26 Jun, 2024 Submission checks completed at journal 26 Jun, 2024 First submitted to journal 26 Jun, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4641482","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":331167153,"identity":"97cd92a6-abcd-414d-857e-66fdff7cb1e8","order_by":0,"name":"Shuhui Huang","email":"","orcid":"","institution":"Xi'an Jiaotong University","correspondingAuthor":false,"prefix":"","firstName":"Shuhui","middleName":"","lastName":"Huang","suffix":""},{"id":331167157,"identity":"c0c3b345-73d7-4ac8-84ca-4c9693415e37","order_by":1,"name":"Xiaoqing Chen","email":"","orcid":"","institution":"Jiangxi Maternal and Child Health Hospital","correspondingAuthor":false,"prefix":"","firstName":"Xiaoqing","middleName":"","lastName":"Chen","suffix":""},{"id":331167159,"identity":"e3885f0f-b446-483e-90ee-ce8f19b63f00","order_by":2,"name":"Danping Liu","email":"","orcid":"","institution":"Jiangxi Maternal and Child Health Hospital","correspondingAuthor":false,"prefix":"","firstName":"Danping","middleName":"","lastName":"Liu","suffix":""},{"id":331167161,"identity":"6c51bb39-6ef5-4531-b0cb-4897cf68ca01","order_by":3,"name":"Huizheng Yuan","email":"","orcid":"","institution":"Jiangxi Maternal and Child Health Hospital","correspondingAuthor":false,"prefix":"","firstName":"Huizheng","middleName":"","lastName":"Yuan","suffix":""},{"id":331167163,"identity":"e3201dd4-c112-43e6-a7f2-c78ade72bd7e","order_by":4,"name":"Yongyi Zou","email":"","orcid":"","institution":"Jiangxi Maternal and Child Health Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yongyi","middleName":"","lastName":"Zou","suffix":""},{"id":331167164,"identity":"85791c17-f90e-469f-9b15-56adffd333b2","order_by":5,"name":"Baitao Zeng","email":"","orcid":"","institution":"Jiangxi Maternal and Child Health Hospital","correspondingAuthor":false,"prefix":"","firstName":"Baitao","middleName":"","lastName":"Zeng","suffix":""},{"id":331167165,"identity":"fcc455a3-40fb-446e-8899-736b054ad4d3","order_by":6,"name":"Guiqin Bai","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1UlEQVRIiWNgGAWjYPACCTl5ZuYDBz5UEK/FwtiwnS3x4IwzxGupSGw4z2N8mLeFCLXy7b0PHxfUSDA2NvN8OMDbwCDPL3YAvxaDM8eNjWcck2BmZ+bdcEByB4PhzNkJBLRIpLFJ87BJsDE2A7UYnmFIMLhNQIv8/Gfsv3n+SfAwHOZ5cCCxjQgtDDfY2Jh52yQkgFoYDhwkRovBmTRmad4+CQPDZjaDgw1nJAj7Rb79GONnnm919fP5Dz/+/KfCRp5fmpDD0IAEacpHwSgYBaNgFGAHAEbYQRAyl+fRAAAAAElFTkSuQmCC","orcid":"","institution":"Xi'an Jiaotong University","correspondingAuthor":true,"prefix":"","firstName":"Guiqin","middleName":"","lastName":"Bai","suffix":""}],"badges":[],"createdAt":"2024-06-26 09:13:04","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4641482/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4641482/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12884-025-08562-4","type":"published","date":"2025-12-09T15:57:16+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":61184266,"identity":"737ebebe-f9f1-4a70-95e2-fd65b25a5622","added_by":"auto","created_at":"2024-07-26 17:12:16","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":74871,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of chromosomal abnormalities in villus samples from 1,490 cases of missed abortion.\u003c/p\u003e\n\u003cp\u003e（A）The proportions of chromosomal abnormalities in villus tissue samples.\u003c/p\u003e\n\u003cp\u003e（B）The distribution of types of chromosomal abnormalities.\u003c/p\u003e\n\u003cp\u003e（C）Details regarding types of chromosomal abnormalities.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4641482/v1/cadd5d13c0682edb1b9fea12.png"},{"id":98243497,"identity":"8872deb1-78b4-4794-85ca-15130ea0d963","added_by":"auto","created_at":"2025-12-15 16:07:04","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1393845,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4641482/v1/36055d3e-21d9-4039-adde-51fd6ccfa985.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Evaluating the link between chromosomal abnormalities and diminished ovarian reserve, mode of conception, and history of prior miscarriages in cases of early missed abortion using CNV-seq","fulltext":[{"header":"Introduction","content":"\u003cp\u003e\u003cem\u003eSpontaneous abortion refers to cases of pregnancy termination without any external intervention prior to a gestational age of 28 weeks when the fetal weight is under 1000 g. This outcome affects an estimated 10-15% of all clinical pregnancies, with over 95% of cases of spontaneous abortion occurring before a gestational age of 12 weeks\u003csup\u003e\u0026nbsp;[1]\u003c/sup\u003e. Missed abortion (MA) cases are a subset of spontaneous abortions in which the fetus or embryo remains within the uterus after death, failing to undergo natural expulsion in a timely manner \u003csup\u003e[2]\u003c/sup\u003e. Many different contributing factors have been linked to MA incidence, including embryonic chromosomal abnormalities, infections, lifestyle factors, parental chromosomal abnormalities, immune activity, endocrine functions, thrombotic disorders, reproductive organ abnormalities, and environmental factors \u003csup\u003e[3]\u003c/sup\u003e. Strikingly, embryonic chromosomal abnormalities are estimated to account for more than 50-60% of all cases of spontaneous abortion \u003csup\u003e[4-5]\u003c/sup\u003e. More advanced maternal age is a key risk factor associated with a greater frequency of embryonic chromosome number abnormalities due to changes in recombination activity with age \u003csup\u003e[6-7]\u003c/sup\u003e. The degree to which other factors including gestational age, ovarian function, mode of conception, and history of prior miscarriages influence the risk of chromosomal abnormalities, however, remains incompletely understood. As published evidence remains contradictory, a retrospective cohort study was herein performed to explore the associations between chromosomal abnormalities and clinical findings in cases of early MAs, including maternal age, ovarian reserve function, the size of the embryo/fetus at the time of abortion, history of prior\u0026nbsp;\u003c/em\u003e\u003cem\u003enatural miscarriages/\u003c/em\u003e\u003cem\u003eMAs\u003c/em\u003e\u003cem\u003e/biochemical pregnancies\u003c/em\u003e\u003cem\u003e, and the use of assisted reproductive technology (ART). The goal of these analyses was to clarify the correlative links between these clinical characteristics and the incidence or characteristics of chromosomal abnormalities in cases of early MA.\u0026nbsp;\u003c/em\u003e\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003e1.1\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eData sources\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis was a retrospective analysis of patients diagnosed with MA who had undergone uterine curettage and low-depth high-throughput whole-genome copy number variation sequencing (CNV-seq) testing at Jiangxi Maternal and Child Health Hospital between June 2020 and December 2022. All testing was performed after receiving written informed consent from patients, with the results being included in this study. MA was diagnosed based on the guidelines for ultrasound-based diagnosis established in 2013 by the American Institute of Ultrasound in Medicine\u0026nbsp;\u003cem\u003e\u003csup\u003e[8]\u003c/sup\u003e\u003c/em\u003e: ① a history of missed menstruation, blood HCG results, or ultrasound confirmation of pregnancy; crown-rump length (CRL) \u0026lt; 45 mm or biparietal diameter \u0026lt; 20 mm, approximately equivalent to a gestational age of less 12 weeks; ② CRL ≥ 7 mm with no heartbeat; ③ Average gestational sac diameter ≥ 25mm, with no embryo; ④ No embryonic heartbeat detected in the gestational sac without a yolk sac after two weeks; ⑤ No embryonic heartbeat detected 11 days after yolk sac detection; and ⑥ No history of infection or toxic compound exposure while pregnant.\u003c/p\u003e\n\u003cp\u003ePatients were excluded if they exhibited biochemical pregnancies, ectopic pregnancies, molar pregnancies, twin/multiple pregnancies, had undergone preimplantation genetic testing (PGS), or had incomplete\u0026nbsp;data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.2 Data collection and grouping\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCases exhibiting karyotypic abnormalities were classified as follows: numerical abnormalities (trisomy, monosomy, sex chromosome trisomy, sex chromosome monosomy, triploidy/polyploidy, double/multiple trisomy), structural abnormalities (chromosomal microdeletion/microduplication), and complex abnormalities (both numerical and structural abnormalities).\u003c/p\u003e\n\u003cp\u003eClinical records were accessed to retrospectively obtain miscarriage-related clinical data, including maternal age, history of natural miscarriages before 12 weeks of pregnancy, ultrasound-based measurements of fetal size at the time of diagnosis, the presence of fetal heartbeat, embryo, and yolk sac, whether anti-Müllerian hormone (AMH) testing had been performed within the past year, and whether the pregnancy was the result of an ART procedure. Patient subgroup classifications were made as follows:\u003c/p\u003e\n\u003cp\u003e① Maternal age at the time of miscarriage: \u0026lt;25 years, 25-29 years, 30-34 years, 35-39 years, or ≥ 40 years.\u003c/p\u003e\n\u003cp\u003e② \u0026nbsp; Ultrasound examination results at the time of miscarriage were used to classify patients based on embryo/fetus size as follows: intrauterine fluid darkness (empty sac), yolk sac visible without embryo, embryo visible without cardiac activity, and cessation of cardiac activity after visible cardiac activity.\u003c/p\u003e\n\u003cp\u003e③ AMH levels: \u0026lt; 1.1 ng/ml, 1.1-4.5 ng/ml, or ≥ 4.5 ng/ml.\u003c/p\u003e\n\u003cp\u003e④\u0026nbsp;Pregnancy method: ART or natural conception (NC).\u003c/p\u003e\n\u003cp\u003e⑤\u0026nbsp;Number of previous natural miscarriages/MAs/biochemical pregnancies before 12 weeks: 0, 1, 2, or ≥ 3 times.\u003c/p\u003e\n\u003cp\u003eThe Medical Ethics Committee of Jiangxi Maternal and Child Health Hospital approved this study (Ethical Approval No: (EC-KY-202011).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.3 Sample Collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUltrasound examinations were performed for all patients after the confirmation of pregnancy, and the diagnosis of MA was confirmed. Chorionic villus samples were aseptically collected from these patients after outpatient surgery. A minimum of 10 mg of chorionic villus tissue per patient was collected with sterile forceps, rinsed with physiological saline, and transferred into a sterile specimen bag for storage at 2-8°C.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.4\u003c/strong\u003e\u003cstrong\u003eExperimental approach\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e① DNA Extraction: Samples were warmed to room temperature, minced, ground, combined with a digestion solution, mixed thoroughly, and centrifuged for 5 min at 2,000. The supernatant was removed, and a QIAamp DNA Blood Mini Kit (Catalog No.: 51106) was used to extract DNA as directed.\u003c/p\u003e\n\u003cp\u003e② CNV-seq analysis: An Agilent 2100 Bioanalyzer was used to assess nucleic acid integrity, while a Nanodrop was used to evaluate the concentration and purity of FNA. Following end repair, adapter ligation adapter-ligated product purification, PCR amplification, and amplicon purification, quantitative analyses were performed. Then, nucleic acid nanoballs were prepared, Qubit quality control was performed, and the BGIseq-500 platform was used for sequencing at a 5 Mb resolution. Sequencing data were aligned to the GRCh37/hg19 reference genome. The American College of Medical Genetics and Genomics guidelines were used for annotation and interpretation. This approach allows for the detection of chromosomal aneuploidy and segmental deletions/duplications exceeding 100 Kb.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e1.5\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eStatistical\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eanalyses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSPSS 23.0 was used to analyze all data. Data are reported as frequencies and percentages, and were analyzed with chi-square or Fisher’s exact tests as appropriate. P \u0026lt; 0.05 was the threshold for significance.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003e2.1\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eCharacterization of chromosomal abnormalities associated with early MAs\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn total, this study included 1490 cases, with a mean age of 31.07 \u0026plusmn; 4.9 years (18-49 years), a mean gravidity of 2.29\u0026plusmn;1.43 (1-11), and a mean parity of 0.35\u0026plusmn;0.62 (0-4). For details regarding the clinical characteristics of these patients, see Table 1.\u003c/p\u003e\n\u003cp\u003eIn the analyzed samples, 540 and 950 cases with normal chromosomes and pathogenic chromosomal abnormalities were detected. The cases with chromosomal abnormalities accounted for 63.76% of all cases, and included 838 cases (88.21%) of numerical abnormalities, 84 (8.84%) of pathogenic Copy number variations(CNVs), and 28 (2.95%) of complex abnormalities. In addition, 118 cases of mosaicism were observed. As no detailed cytogenetic analyses were performed, these mosaicism cases were included in the groups with numerical abnormalities and CNVs. This study only included pathogenic CNVs, whereas benign CNVs or those of unknown significance were not included.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOf the detected\u0026nbsp;chromosomal\u0026nbsp;abnormalities, instances of single autosomal trisomy (n=573, 68.38%) were the most common, followed by triploidy/polyploidy (n=111, 11.68%), 45XO (n=103, 10.84%), and double/multiple trisomy (n=41, 4.32%). In addition, 3 cases (0.32%) of sex chromosome trisomy/polyploidy were detected, including 1 instance of 46,XXX, 1 of 47,XXX mosaic duplication (mosaicism ratio: 55%), and 1 of 49,XXXXY.\u003c/p\u003e\n\u003cp\u003eOf the single autosomal trisomies detected in this analysis, trisomies 16 and 22 were the most common, with 160 (16.85%) and 102 (10.74%) respective cases. Trisomy 21 was detected in 42 cases (4.42%), trisomy 15 was detected in 39 cases (4.11%), and trisomy 13 was detected in 37 cases (3.89%). There were no instances of trisomy 19, and trisomy 1 was only detected in a single case of mosaic duplication (mosaicism ratio: 19%) (see Table 2 and Figure 1).\u003c/p\u003e\n\u003cp\u003eTable 1: The clinical characteristics of missed abortion cases with available cytogenic results (n=1490)\u003c/p\u003e\n\u003cdiv align=\"Left\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"498\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eMaternal age（years）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e31.07\u0026plusmn;4.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003e＜25\u0026nbsp;（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e113(7.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003e25-29（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e489(32.82)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003e30-34（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e546(36.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003e35-39（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e256(17.18)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003e\u0026ge;40（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e\u0026nbsp; 86(5.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003egravidity（n）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e2.29\u0026plusmn;1.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eParity（n）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e0.35\u0026plusmn;0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eNumber of prior missed abortion\u0026nbsp;at\u0026nbsp;＜12 weeks（n）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e1490\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eNone（n%） \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e924(62.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eOne（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e370(24.83)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eTwo（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e140(9.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eThree or more（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e56(3.76)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eMode ofconception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e1490\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eNC（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e1145(76.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eART（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e345(23.15)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eOvarian reserve \u0026nbsp;a\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e700\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003e＜1.1ng/ml（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e87(12.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003e1.1-4.5ng/ml（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e389(55.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003e\u0026ge;4.5ng/ml（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e224(32.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eUltrasound prompts fetal size(total)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e1490\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eEmpty sac（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e258(17.32)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eSee yolk sac（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e298(20.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eSee germ without fetal heart（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e382(25.64)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"63.45381526104418%\" valign=\"top\" style=\"width: 77.5862%;\"\u003e\n \u003cp\u003eStop after seeing fetal heart rate（n%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.27309236947791%\" valign=\"top\" style=\"width: 22.4138%;\"\u003e\n \u003cp\u003e552(37.05)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eContinuous variables are shown as the mean (standard deviation). Categorical variables are shown as n (%).\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ea\u003c/sup\u003eThe total number of cases was 700.\u003c/p\u003e\n\u003cp\u003eComplex abnormalities were defined as those involving both chromosome number and structural abnormalities.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 \u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eChromosomal Abnormality Distributions as a Function of Gestational Age\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGiven the potential for delayed ovulation or the delayed diagnosis of miscarriage, ultrasound results were used to classify miscarriages before 12 weeks into four categories: empty yolk sac, visible\u0026nbsp;yolk sac, embryo visible\u0026nbsp;without\u0026nbsp;cardiac activity, and cessation of cardiac activity\u0026nbsp;after\u0026nbsp;visible cardiac activity. Chromosomal abnormalities in these four respective groups were observed in 123 cases (47.67%), 192 cases (64.63%), 265 cases (69.37%), and 370 cases (67.03%). The lowest rate of chromosomal abnormality detection was observed in the empty sac group, and the detection rate rose significantly following the appearance of the yolk sac (\u0026chi;2=36.71, P\u0026lt;0.01).\u003c/p\u003e\n\u003cp\u003eTrisomy was most frequently detected in the group with a visible embryo but no cardiac activity (\u0026chi;2=85.225, P\u0026lt;0.01), while 45XO was most frequently detected abnormality in the group in which cardiac activity had ceased\u0026nbsp;after\u0026nbsp;detection of a\u0026nbsp;fetal\u0026nbsp;heartbeat (\u0026chi;2=103.101, P\u0026lt;0.01), and CNVs were most commonly detected in the empty sac group (\u0026chi;2=86.441, P\u0026lt;0.01). Double/multiple trisomy was most frequently detected in the group with a visible\u0026nbsp;yolk sac (\u0026chi;2=13.88, P\u0026lt;0.01), whereas higher triploidy/polyploidy detection rates were observed in the empty sac group and the group in which cardiac activity had ceased\u0026nbsp;after\u0026nbsp;detection of a\u0026nbsp;fetal\u0026nbsp;heartbeat (\u0026chi;2=76.21, P\u0026lt;0.01) (Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eChromosomal Abnormality Distributions as a Function of Maternal Age\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong cases with a maternal age of \u0026lt; 25 years, 25-29 years, 30-34 years, 35-39 years, and \u0026ge; 40 years, chromosomal abnormalities were respectively detected in 74 (65.49%), 304 (62.17%), 332 (60.81%), 171 (66.80%), and 69 (80.23%) cases. The lowest detection rate was observed for maternal ages from 25-34, whereas a significant increase in these rates was observed among women aged \u0026ge;40 years (\u0026chi;2=67.122, P\u0026lt;0.01).\u003c/p\u003e\n\u003cp\u003eTrisomy detection rates rose gradually with age, including a sharp increase after 35 years of age (\u0026chi;2=58.551, P\u0026lt;0.01). The rates of CNVs and 45XO detection, in contrast, were highest when the maternal age was \u0026lt; 25 years and gradually declined with increasing age (\u0026chi;2=24.708, P\u0026lt;0.01; \u0026chi;2=11.488, P\u0026lt;0.05). Triploidy/polyploid detection rates were higher among individuals \u0026lt; 34 years of age, declining sharply above the age of 35 (\u0026chi;2=20.21, P\u0026lt;0.01). Double/multiple trisomy detection rates rose with age, including a pronounced but non-significant increase above the age of 40 (P\u0026gt;0.05). No significant differences in the detection rates of other types of chromosomal abnormalities were observed across these age groups (P\u0026gt;0.05) (see Table 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.4\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eChromosomal\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAbnormality Distributions as a Function of Ovarian Reserve\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf these 1,490 cases, AMH testing had been performed within the last 12 months in 700 cases. Patients were classified based on AMH levels into three groups: \u0026lt; 1.1 ng/ml, 1.1-4.5 ng/ml, and \u0026ge; 4.5 ng/ml. Chromosomal abnormalities were detected in 62 (71.26%), 234 (60.15%), and 123 (54.91%) of cases in these groups, respectively, with detection rates increasing significantly as AMH levels declined (\u0026chi;2=7.007, P\u0026lt;0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWhen analyzing the distributions of chromosomal abnormality types across these three respective groups, trisomy rates were found to rise whereas triploidy/polyploidy detection rates declined significantly (74.19% vs. 66.67% vs. 56.10%, \u0026chi;2=6.826, P\u0026lt;0.05; 8.06% vs. 8.55% vs. 17.07%, \u0026chi;2=6.629, P\u0026lt;0.05). The 45XO detection rate declined with decreasing ovarian reserve function, although the changes were not significant (3.23% vs. 9.83% vs. 11.38%, \u0026chi;2=4.034, P\u0026gt;0.05).\u003c/p\u003e\n\u003cp\u003eAs age is independently associated with the risk of chromosomal abnormalities, an age-based stratified analysis was conducted. When stratifying according to age, chromosomal abnormalities were detected in these three respective\u0026nbsp;ovarian reserve groups\u0026nbsp;among patients\u0026nbsp;\u0026ge;35 years old in\u0026nbsp;38 (77.55%), 76 (66.09%), and 20 (80.00%) cases, whereas among patients \u0026lt;35 years old they were detected in 24 (63.16%), 158 (57.66%), and 103 (51.76%) cases, respectively. A higher but non-significant increase in chromosomal abnormality detection rate was observed in the low ovarian reserve group (\u0026lt; 1 ng/mL) for both patients \u0026lt;\u0026nbsp;35\u0026nbsp;and\u0026nbsp;\u0026ge; 35 years of age\u0026nbsp;(P\u0026gt;0.05).\u0026nbsp;No significant\u0026nbsp;differences in chromosomal\u0026nbsp;abnormality distributions were observed\u0026nbsp;among other groups\u0026nbsp;when stratifying cases based on\u0026nbsp;age (P\u0026gt;0.05) (Table 4).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.5 Distribution of Chromosomal Abnormalities as a Function of the Mode of\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Conception\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWhen these 1,490 cases were classified into ART and NC groups according to the mode of conception, chromosomal abnormalities were detected in 189 (54.78%) and 761 (66.46%) cases, with a significantly lower detection rate in the ART group relative to the NC group (\u0026chi;2=175.977, P\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003eWhen cases were stratified according to age, chromosomal abnormalities were detected in 84 and 156 cases in the ART and NC subgroups, respectively, among patients with a maternal age \u0026ge; 35 years, while among patients \u0026lt; 35 years of age they were detected in 105 and 605 cases in these two respective groups. A significant reduction in the rate of chromosomal abnormalities was detected in the ART group among patients \u0026lt; 35 years old (65.19%\u0026nbsp;vs. 47.73%, \u0026chi;2=22.993, P\u0026lt;0.05),\u0026nbsp;while\u0026nbsp;a similar detection rate was evident in both the ART and NC groups among women \u0026ge; 35 years of age (71.89% vs. 67.20%,\u0026nbsp;\u0026chi;2=0.833, P\u0026gt;0.05).\u003c/p\u003e\n\u003cp\u003eRelative to the NC group, the ART group exhibited significantly increased rates of trisomy (57.56% vs. 71.43%, \u0026chi;2 = 12.432, P\u0026lt;0.05), whereas the corresponding rates of CNVs and triploidy/polyploidy detection decreased (9.86% vs. 4.76%, \u0026chi;2=10.561, P\u0026lt;0.05; 13.01% vs. 6.35%, \u0026chi;2=10.561, P\u0026lt;0.05).\u003c/p\u003e\n\u003cp\u003eFollowing age-based stratification, the ART group exhibited a significantly lower rate of triploidy/polyploidy detection relative to the NC group among patients \u0026lt; 35 years of age (15.37% vs. 8.57%, \u0026chi;2=18.17, P\u0026lt;0.05), while a non-significant increase in the trisomy detection rate was observed in both the \u0026ge; 35 and \u0026lt; 35 year ART groups (53.29% vs. 60.95%,\u0026nbsp;\u0026chi;2=2.064, P\u0026gt;0.05; 73.72% vs. 84.52%, \u0026chi;2=3.656, P\u0026gt;0.05). No significant differences were observed for the comparisons among any other groups (P\u0026gt;0.05) (Table 5).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.6 Associations Between Numbers of MAs and Chromosomal Abnormalities\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudy subjects were separated into four groups based on whether they had experienced 0, 1, 2, or \u0026ge; 3 prior instances of natural miscarriage/MA/biochemical pregnancy. Chromosomal abnormalities were detected in 589 (64.16%), 240 (64.00%), 88 (62.4%), and 33 (58.93%) cases in these respective groups. As the number of prior miscarriages rose, the abnormal karyotype detection rate declined, albeit non-significantly (P\u0026gt;0.05). No differences in chromosomal abnormality detection rates were observed when stratifying patients based on whether they were \u0026lt;35 or \u0026ge;35 years of age (P\u0026gt;0.05).\u003c/p\u003e\n\u003cp\u003eChromosomal abnormality type distributions were analyzed across groups, revealing no significant differences in these distributions among groups (see Table 5).\u003c/p\u003e\n\u003cp\u003eTable 3: Associations between chromosomal abnormality detection rates, fetal size, and maternal age\u0026nbsp;\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"736\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.061224489795919%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"40.27210884353742%\" colspan=\"5\" valign=\"bottom\"\u003e\n \u003cp\u003eUltrasound prompts fetal size\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"46.666666666666664%\" colspan=\"6\" valign=\"bottom\"\u003e\n \u003cp\u003ePatient age（years）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.061224489795919%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931972789115646%\" valign=\"bottom\"\u003e\n \u003cp\u003eEmpty capsule\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" valign=\"bottom\"\u003e\n \u003cp\u003eSee yolk sac\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003eSee germ without fetal heart\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003eStop after seeing fetal heart rate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.98639455782313%\" valign=\"bottom\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e＜25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.70748299319728%\" valign=\"bottom\"\u003e\n \u003cp\u003e25-29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.891156462585034%\" valign=\"bottom\"\u003e\n \u003cp\u003e30-34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e35-40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.482993197278912%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026ge;40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.394557823129252%\" valign=\"bottom\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.061224489795919%\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931972789115646%\" valign=\"bottom\"\u003e\n \u003cp\u003e135（52.33）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" valign=\"bottom\"\u003e\n \u003cp\u003e106（35.57）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e117（30.63）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e182（32.97）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.98639455782313%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e39（34.51）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.70748299319728%\" valign=\"bottom\"\u003e\n \u003cp\u003e185（37.83）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.891156462585034%\" valign=\"bottom\"\u003e\n \u003cp\u003e214（39.19）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e85（33.20）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.482993197278912%\" valign=\"bottom\"\u003e\n \u003cp\u003e17（19.77）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.394557823129252%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.061224489795919%\"\u003e\n \u003cp\u003eChromosome abnormality\u0026nbsp;（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931972789115646%\" valign=\"bottom\"\u003e\n \u003cp\u003e123(47.67)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" valign=\"bottom\"\u003e\n \u003cp\u003e192(64.63)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e265(69.37）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e370（67.03）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.98639455782313%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e74（65.49）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.70748299319728%\" valign=\"bottom\"\u003e\n \u003cp\u003e304（62.17）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.891156462585034%\" valign=\"bottom\"\u003e\n \u003cp\u003e332（60.81）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e171(66.80）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.482993197278912%\" valign=\"bottom\"\u003e\n \u003cp\u003e69（80.23）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.394557823129252%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.061224489795919%\"\u003e\n \u003cp\u003eAutosomal trisomy（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931972789115646%\" valign=\"bottom\"\u003e\n \u003cp\u003e49(39.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" valign=\"bottom\"\u003e\n \u003cp\u003e133(69.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e209(78.87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e18(49.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.98639455782313%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e31（41.89）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.70748299319728%\" valign=\"bottom\"\u003e\n \u003cp\u003e154（50.66）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.891156462585034%\" valign=\"bottom\"\u003e\n \u003cp\u003e202（60.84）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e127 (74.27）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.482993197278912%\" valign=\"bottom\"\u003e\n \u003cp\u003e59（85.51）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.394557823129252%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.061224489795919%\"\u003e\n \u003cp\u003eAutosomal haploid（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931972789115646%\" valign=\"bottom\"\u003e\n \u003cp\u003e1(0.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" valign=\"bottom\"\u003e\n \u003cp\u003e1(0.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e3(1.13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e(0.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.98639455782313%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.70748299319728%\" valign=\"bottom\"\u003e\n \u003cp\u003e3(0.99）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.891156462585034%\" valign=\"bottom\"\u003e\n \u003cp\u003e3（0.90）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e1(0.58）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.482993197278912%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.394557823129252%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.061224489795919%\"\u003e\n \u003cp\u003eSex chromosome trisomy/polytomy（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931972789115646%\" valign=\"bottom\"\u003e\n \u003cp\u003e0(0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" valign=\"bottom\"\u003e\n \u003cp\u003e0(0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e0(0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e(0.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.98639455782313%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.70748299319728%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.891156462585034%\" valign=\"bottom\"\u003e\n \u003cp\u003e1(0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e2(1.17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.482993197278912%\" valign=\"bottom\"\u003e\n \u003cp\u003e0(0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.394557823129252%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.061224489795919%\"\u003e\n \u003cp\u003eMonosomy X\u0026nbsp;（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931972789115646%\" valign=\"bottom\"\u003e\n \u003cp\u003e8(6.50)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" valign=\"bottom\"\u003e\n \u003cp\u003e2(1.04)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e6(2.26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e8(23.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.98639455782313%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e17(22.97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.70748299319728%\" valign=\"bottom\"\u003e\n \u003cp\u003e43(14.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.891156462585034%\" valign=\"bottom\"\u003e\n \u003cp\u003e34(10.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e8（4.68）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.482993197278912%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（1.45）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.394557823129252%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.061224489795919%\"\u003e\n \u003cp\u003eDouble/multiple\u0026nbsp;trisomy（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931972789115646%\" valign=\"bottom\"\u003e\n \u003cp\u003e7(5.69)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" valign=\"bottom\"\u003e\n \u003cp\u003e16(8.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e10(3.77)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e8(2.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.98639455782313%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e1(1.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.70748299319728%\" valign=\"bottom\"\u003e\n \u003cp\u003e15(4.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.891156462585034%\" valign=\"bottom\"\u003e\n \u003cp\u003e12(3.61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e8(4.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.482993197278912%\" valign=\"bottom\"\u003e\n \u003cp\u003e5(7.25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.394557823129252%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.061224489795919%\"\u003e\n \u003cp\u003eTriploidy/Polyploidy（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931972789115646%\" valign=\"bottom\"\u003e\n \u003cp\u003e15(12.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" valign=\"bottom\"\u003e\n \u003cp\u003e16(8.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e20(7.55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e60(16.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.98639455782313%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e10(13.51)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.70748299319728%\" valign=\"bottom\"\u003e\n \u003cp\u003e45(14.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.891156462585034%\" valign=\"bottom\"\u003e\n \u003cp\u003e47(14.16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e8(4.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.482993197278912%\" valign=\"bottom\"\u003e\n \u003cp\u003e1(1.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.394557823129252%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.061224489795919%\"\u003e\n \u003cp\u003eMicrodeletion and Microdupliction（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931972789115646%\" valign=\"bottom\"\u003e\n \u003cp\u003e37（30.08）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" valign=\"bottom\"\u003e\n \u003cp\u003e20（10.42）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e9（3.40）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e18（4.86）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.98639455782313%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e12（16.22）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.70748299319728%\" valign=\"bottom\"\u003e\n \u003cp\u003e32（10.53）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.891156462585034%\" valign=\"bottom\"\u003e\n \u003cp\u003e26（7.83）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e13(7.60）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.482993197278912%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（1.45）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.394557823129252%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"13.061224489795919%\"\u003e\n \u003cp\u003eComplex abnormality\u0026nbsp;（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.931972789115646%\" valign=\"bottom\"\u003e\n \u003cp\u003e6（4.88）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.16326530612245%\" valign=\"bottom\"\u003e\n \u003cp\u003e4（2.08）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e8(3.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e10(2.70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.98639455782313%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.755102040816326%\" valign=\"bottom\"\u003e\n \u003cp\u003e3（4.05）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.70748299319728%\" valign=\"bottom\"\u003e\n \u003cp\u003e12（3.95）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.891156462585034%\" valign=\"bottom\"\u003e\n \u003cp\u003e7（2.11）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.435374149659864%\" valign=\"bottom\"\u003e\n \u003cp\u003e4 (2.34）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.482993197278912%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（2.90）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.394557823129252%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable 4: Relationships between chromosomal abnormality detection rates and AMH levels\u0026nbsp;\u003c/p\u003e\n\u003cdiv align=\"Left\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"464\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"70.3225806451613%\" colspan=\"5\" valign=\"bottom\"\u003e\n \u003cp\u003eOvarian reserve\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAMH\u003c/strong\u003e\u003cstrong\u003e＜\u003c/strong\u003e\u003cstrong\u003e1.10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAMH1.10-4.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\"\u003e\n \u003cp\u003e\u003cstrong\u003eAMH\u003c/strong\u003e\u003cstrong\u003e＞\u003c/strong\u003e\u003cstrong\u003e4.5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003ex2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\" valign=\"bottom\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e25（28.74）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e155（39.85）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e101（45.09）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e14（36.84）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e116（42.34）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e96（48.24）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e11（22.45）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e39（33.91）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e5（20.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003eChromosome abnormality\u0026nbsp;（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e62（71.26）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e234（60.15）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e123（54.91）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e7.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e24（63.16）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e158（57.66）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e103（51.76）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.537\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e38（77.55）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e76（66.09）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e20（80.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e3.345\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003eAutosomal trisomy（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e46（74.19）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e156（66.67）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e69（56.10）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e6.826\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e13（54.17）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e90（56.96）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e55（53.40）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.338\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e33（86.84）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e66（86.84）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e14（70.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e3.652\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003eAutosomal haploid（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003eSex chromosome trisomy/polytomy（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003eMonosomy X\u0026nbsp;（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（3.23）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e23（9.83）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e14（11.38）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e4.034\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（4.17）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e23（14.56）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e14（13.59）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.956\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（2.63）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（5.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e3.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003eDouble/multiple trisomy（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（3.23）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e8（3.42）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e3（2.44）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.316\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（4.17）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e6（3.80）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（1.94）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.789\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（2.63）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（2.63）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（5.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.285\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003eTriploidy/Polyploidy（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e5（8.06）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e20（8.55）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e21（17.07）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e6.629\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e4（16.67）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e18（11.39）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e19（18.45）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（2.63）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（2.63）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（10.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e2.572\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003eMicrodeletion and Microdupliction（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e4（6.45）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e21（8.97）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e11（8.94）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.425\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e3（12.50）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e16（10.13）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e9（8.74）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.347\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（2.63）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e5（6.58）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（10.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e1.383\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003eComplex abnormality\u0026nbsp;（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（3.23）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e6（2.56）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e4（3.25）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.439\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（8.33）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e5（3.16）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e4（3.88）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e111.526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026lt;0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"21.72043010752688%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.956989247311828%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.483870967741936%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.559139784946236%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（1.32）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.268817204301076%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.817204301075268%\" valign=\"bottom\"\u003e\n \u003cp\u003e0.769\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.193548387096774%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eTable 5: Relationships between chromosomal abnormality detection rates, mode of conception, and history of prior MAs\u0026nbsp;\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"675\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.623145400593472%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.93768545994065%\" colspan=\"4\" valign=\"bottom\"\u003e\n \u003cp\u003eMode of conception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"46.439169139465875%\" colspan=\"5\"\u003e\n \u003cp\u003eNumber of prior missed abortion at\u0026nbsp;＜12 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\" valign=\"bottom\"\u003e\n \u003cp\u003eAssisted reproductive technology\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003eNatural conception\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\" valign=\"bottom\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\"\u003e\n \u003cp\u003e\u0026ge;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\" valign=\"bottom\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e156(45.22)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e384(33.54)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e329（35.61）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e133（35.95）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;55（39.29）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e23（41.07）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e115(52.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e323(34.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e275（38.35）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e110（37.16）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e41（38.32）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e12（42.86）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e41(32.80)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e61(28.11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e54（26.09）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e23（31.08）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e14（42.42）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e11（39.29）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003eChromosome abnormality\u0026nbsp;（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e189(54.78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e761（66.46）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e595（64.39）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e237（64.05）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e859(60.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e33(58.93)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e105(47.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e605（65.19）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e442(61.65）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e186（62.84）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e66(61.68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\"\u003e\n \u003cp\u003e16(57.14)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e84(67.20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e156（71.89）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e153（73.91）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e51(68.92)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e19(57.58)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e17(60.71)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003eAutosomal trisomy（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e135(71.43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e438（57.56）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e370（62.18）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e136(57.38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e43(50.59)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e24 (72.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e64(60.95)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e323（53.39）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e252(57.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e95 (51.08)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e30(45.45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e10(62.5)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e71(84.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e115（73.72）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e118（77.12）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e41(80.39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e13(68.42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e14(82.35)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003eAutosomal haploid（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e1(0.53)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e6（0.79）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e6（1.01）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（1.18）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e0(0.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e6（0.99）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\" valign=\"bottom\"\u003e\n \u003cp\u003e5（1.13）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（1.52）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e1(1.19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（0.65）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003eSex chromosome trisomy/polytomy（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e3（0.26）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e2（0.34）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（1.18）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e1（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e2（1.28）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e1（0.65）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（5.26）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003eMonosomy X\u0026nbsp;（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e16（8.47）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e87（11.43）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e59（9.92）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e32（13.50）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e10（11.76）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（6.06）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e13（12.38）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e81（13.39）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e52（11.76）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e30（16.13）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e10（15.15）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\"\u003e\n \u003cp\u003e2（12.50）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e3（3.57）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e6（3.85）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e7（4.58）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（3.92）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003eDouble/multiple trisomy（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e9（4.76）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e32（4.20）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e22（3.70）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e11（4.64）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e7（8.24）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（3.03）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e6（5.71）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e22（3.64）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e15（3.39）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e9\u0026nbsp;（4.84）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e4（6.06）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u0026nbsp;（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e3（3.57）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e10（6.41）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e7（4.58）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（3.92）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e3（15.79）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e1（5.88）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003eTriploidy/Polyploidy（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e12（6.35）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e99（13.01）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e67（11.26）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e33（13.92）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e9（10.59）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（6.06）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e9（8.57）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e9（15.37）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e62（14.03）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e30（16.13）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e9（13.64）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（12.50）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e3（3.57）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e6（3.85）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e6（3.92）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e3（5.88）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003eMicrodeletion and Microdupliction（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e9（4.76）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e75（9.86）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\" valign=\"bottom\"\u003e\n \u003cp\u003e50（8.40）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e18\u0026nbsp;（7.59）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e12（14.12）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\"\u003e\n \u003cp\u003e4（12.12）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e7（6.67）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e63（10.41）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\" valign=\"bottom\"\u003e\n \u003cp\u003e41（9.28）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e17（9.14）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e10（15.15）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（12.50）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e2（2.38）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e12（7.69）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\" valign=\"bottom\"\u003e\n \u003cp\u003e9（5.88）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e1（1.96）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（10.53）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（11.76）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003eComplex abnormality\u0026nbsp;（n/%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003etotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e7（3.70）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e21（2.76）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\" valign=\"bottom\"\u003e\n \u003cp\u003e19（3.19）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e7（2.95）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（2.35）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e0\u0026nbsp;（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e＜35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e6（5.71）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e16（2.64）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\" valign=\"bottom\"\u003e\n \u003cp\u003e15（3.39）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e5（2.69）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（3.03）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.59259259259259%\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.925925925925926%\"\u003e\n \u003cp\u003e\u0026ge;35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\"\u003e\n \u003cp\u003e1（1.19）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\"\u003e\n \u003cp\u003e5（3.21）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.518518518518518%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.814814814814815%\" valign=\"bottom\"\u003e\n \u003cp\u003e4（2.61）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.62962962962963%\" valign=\"bottom\"\u003e\n \u003cp\u003e2（3.92）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.777777777777779%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.185185185185185%\" valign=\"bottom\"\u003e\n \u003cp\u003e0（0.00）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.111111111111111%\" valign=\"bottom\"\u003e\n \u003cp\u003e＞0.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eChromosomal integrity is vital to embryo survival, with chromosomal abnormalities typically resulting in spontaneous abortion or intrauterine fetal demise. Analyses of embryo chromosomal status in cases of early MA can provide insight into the causes of miscarriage. Conventional chromosome G-banding techniques have historically been used for the karyotyping of miscarriage products. This strategy, however, is only capable of detecting certain chromosomal abnormalities and it is subject to limitations including the need for extended cell culture, susceptibility to contamination with maternal cells, poor microscopic resolution, and high rates of failure.\u003c/p\u003e\n\u003cp\u003eMolecular genetic techniques have recently emerged as strategies that can overcome the limitations of chromosomal karyotyping in the clinic. Low-depth high-throughput whole-genome CNV-seq strategies can effectively detect chromosomal structural abnormalities, including microdeletions and microduplications under 100 kb in size. CNV-seq is also inexpensive, easy to implement, and rapid such that it is widely used for the chromosomal characterization of miscarriage products. Here, cases that had undergone CNV-seq analyses were retrospectively evaluated to characterize chromosomal abnormalities in cases of MA and to explore correlations between these abnormalities and patient clinical data.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.1 Chromosomal Abnormality Distribution Frequencies\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOver 50% of MAs result from chromosomal abnormalities, with previous studies estimating anywhere from 50-70% of MAs to be associated with these abnormalities\u0026nbsp;\u003cem\u003e\u003csup\u003e[9-11]\u003c/sup\u003e\u003c/em\u003e. Variations in these rates may be the result of gestational age, the detection techniques employed, and other variables. Here, 950 of the analyzed cases (63.76%) were found to harbor karyotypic abnormalities, with chromosomal aneuploidy being the most common finding\u0026nbsp;\u003cem\u003e\u003csup\u003e[12]\u003c/sup\u003e\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003eChromosomal aneuploidy is the most prevalent cause of MA or intrauterine fetal demise. These abnormalities entail the absence or presence of particular chromosomes owing to errors that arise during the first round of meiotic division giving rise to an egg cell\u0026nbsp;\u003cem\u003e\u003csup\u003e[13]\u003c/sup\u003e\u003c/em\u003e. Autosomal trisomy is the most common finding in cases of early MA, with trisomies 13, 16, 18, 21, and 22 being particularly frequent\u003cem\u003e\u003csup\u003e[14]\u003c/sup\u003e\u003c/em\u003e, followed by X monosomy and polyploidy\u0026nbsp;\u003cem\u003e\u003csup\u003e[9,10]\u003c/sup\u003e\u003c/em\u003e. For instance, one prior survey of 1,030 products of conception from MAs following single-embryo transfer detected aneuploidy in 80.6% of cases, of which 62.3% were trisomies, 7.8% were double trisomies, 0.5% were triploid or tetraploid, 1.3% exhibited 21-monosomy, 3.2% exhibited X-monosomy, 0.1% exhibited 47,XXY, 1.0% exhibited polyploidy, 1.0% presented with mixed abnormalities, 1.1% exhibited embryonic chimerism, and 2.4% exhibited structural\u0026nbsp;abnormalities\u003cem\u003e\u0026nbsp;\u003csup\u003e[15]\u003c/sup\u003e\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003eA separate cytogenetic analysis of embryos from 1,011 cases of early pregnancy loss revealed chromosomal abnormalities in 711 cases (70.3%)\u0026nbsp;\u003cem\u003e\u003csup\u003e[16]\u003c/sup\u003e\u003c/em\u003e. The most commonly reported abnormalities in these cases included autosomal trisomies (64.6%), triploidy (13.1%), and X monosomy (10.4%). In the present cohort, the most frequently detected abnormalities included trisomy 16 (16.85%), 45XO (10.84%), trisomy 22 (10.74%), trisomy 21 (4.42%), trisomy 15 (4.11%), and trisomy 13 (3.89%), in line with these past results. Triploidy/polyploidy was the second most frequent abnormality in this cohort (11.68%), including two cases of sex chromosome trisomy (one each of 47,XXX and 47,XXX with chimeric duplication and a chimerism ratio of 55%). X tetraploidy was also observed in one case (49,XXXXY). There were no instances of trisomy 19, while trisomy 1 was only detected in a single case of chimeric duplication (chimerism ratio: 19%). Chromosome 19 exhibits the highest gene density in the human genome, whereas the greatest number of genes is encoded on chromosome 1. Trisomy 19 or 1 may thus be lethal at an early stage of embryogenesis.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eChromosomal Abnormalities and Gestational Age\u003c/strong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere have been multiple past reports indicating that the detection rates and types of cytogenetic abnormalities in cases of early MA before 12 weeks gestation vary markedly as a function of embryo/fetus size, emphasizing the important roles that particular chromosomal factors play during the early phases of embryonic/fetal development\u003cem\u003e\u003csup\u003e[17]\u003c/sup\u003e\u003c/em\u003e. The yolk sac precedes pregnancy, and its absence is indicative of a blighted ovum, most often as a consequence of poor embryonic development and premature demise. The embryo develops early during fetal development, with the pulsation of the primitive heart tube being the first indicator of fetal cardiac development. The yolk sac tends to appear around week 5 of pregnancy, with the embryo and fetal heart first manifesting at approximately weeks 6-7. The frequencies of embryo and fetal heart rate detection have been reported to be higher in cases of viable trisomies, X monosomy, and triploid miscarriages as compared to cases of karyotypic normality or miscarriages with other karyotypic abnormalities\u0026nbsp;\u003cem\u003e\u003csup\u003e[18]\u003c/sup\u003e\u003c/em\u003e. A CRL of less than 15 mm is most commonly associated with other forms of trisomy or structural trisomy in 57.7% and 11.5% of cases, respectively, whereas a CRL ≥ 15 mm is instead associated with instances of monosomy (38.7%), triploidy (29%), and viable trisomy (12.9%)\u003cem\u003e\u003csup\u003e[19]\u003c/sup\u003e\u003c/em\u003e. Postmortem embryo pole length also reportedly varies significantly across karyotype groups, with the longest lengths in cases of trisomy 21, X monosomy, and triploidy at 16, 15.3, and 11.6 mm, respectively\u0026nbsp;\u003cem\u003e\u003csup\u003e[20]\u003c/sup\u003e\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003eHere, the lowest rate of chromosomal abnormality detection was evident in the group in which the yolk sac was empty, whereas this rate rose significantly after yolk sac detection. Trisomies were most often detected in the yolk sac and embryo groups, whereas their detection rates were comparatively lower in the groups exhibiting an empty sac or cardiac pulsation. The 45XO detection rate was highest in the group with cardiac pulsation, supporting the differing developmental potentials of embryos harboring particular chromosomal abnormalities, with trisomy being related to embryogenesis and fetal heart development\u003cem\u003e\u003csup\u003e[15]\u003c/sup\u003e\u003c/em\u003e. Certain forms of trisomy, including trisomy 16, are potentially associated with early embryonic development\u003cem\u003e\u003csup\u003e[20]\u003c/sup\u003e\u003c/em\u003e, whereas 45XO appears to have no effect on the early stages of embryo growth.\u003c/p\u003e\n\u003cp\u003eNobuaki et al\u003cem\u003e\u003csup\u003e[17\u003c/sup\u003e\u003c/em\u003e\u003csup\u003e]\u0026nbsp;\u003c/sup\u003eobserved no variations in triploidy or chromosomal structural abnormality frequencies as a function of gestational age. Igher embryonic development rates have been reported for cases of triploidy, X monosomy, and trisomy 21 as compared to other karyotypic findings\u0026nbsp;\u003cem\u003e\u003csup\u003e[19]\u003c/sup\u003e\u003c/em\u003e. Segawa et al\u003cem\u003e\u003csup\u003e[15]\u003c/sup\u003e\u003c/em\u003eposited that double trisomy and triploidy events are significantly more common when no fetal heartbeat is detected, and that higher karyotypic abnormality rates are related to blighted ovum\u003cem\u003e\u003csup\u003e[21]\u003c/sup\u003e\u003c/em\u003e. In the present study, the distributions of double/multiple trisomies, triploidy, and CNVs varied as a function of gestational age. The highest rate of double/multiple trisomy detection was evident in the yolk sac group, whereas triploidy was most commonly detected in the empty sac and cardiac pulsation groups. CNVs were more common in the empty sac group, suggesting that while triploidy/multiploidy are more likely to result in very early or later miscarriage, CNVs are linked to higher odds of very early miscarriage. The proportion of karyotypic abnormalities in the very early MA group with an empty yolk sac was relatively low, whereas the abnormality detection rate rose after the yolk sac was evident. This supports the important role of non-genetic factors including infections, immune activity, clotting, and other environmental factors in very early pregnancy failure\u0026nbsp;\u003cem\u003e\u003csup\u003e[12]\u003c/sup\u003e\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3 Chromosomal Abnormalities as a Function of Maternal Age and Ovarian Reserve\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePrimary oocytes develop from primordial germ cells at ~3 months of fetal development and enter into dormancy for decades after undergoing meiosis I and genetic recombination, only resuming meiosis I and entering metaphase II prior to ovulation. Errors that impact chromosomal segregation can occur at each stage of meiosis and become more common as maternal age rises\u0026nbsp;\u003cem\u003e\u003csup\u003e[22]\u003c/sup\u003e\u003c/em\u003e. Chromosomal aneuploidies in human gametes and pre-implantation embryos are a common cause of pregnancy failure or infertility. Aneuploidy impacts an estimated 20% of human oocytes, and this number rises exponentially from ages 30-35, reaching 80% as of age 42\u0026nbsp;\u003cem\u003e\u003csup\u003e[7]\u003c/sup\u003e\u003c/em\u003e. Indeed, maternal age is firmly established as a factor that is closely associated with chromosomal aneuploidy\u0026nbsp;\u003cem\u003e\u003csup\u003e[23]\u003c/sup\u003e\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003eHere, patients were grouped according to maternal age in 5-year intervals, revealing that rates of chromosomal abnormalities were lowest among women ages 25-34 (62.17%, 60.81%), whereas these rates rose with age to a peak of 80.23% for women ≥40 years of age. The chromosomal abnormality detection rate began increasing significantly from age 30 to 34, raising the question of whether ovary aging begins to manifest at 30. However, an analysis of the types of chromosomal abnormalities associated with these different age groups revealed that trisomy detection rates began rising from age 35-40 (74.85%) to even higher levels after age 40 (85.51%). In contrast, 45XO detection rates peaked in cases where the mother was \u0026lt; 25 years old (22.97%), gradually declining with age to 10.24% at 30-34 and further declining in the 35-40 age group. Women 35+ years of age thus face higher odds of trisomy\u003cem\u003e\u003csup\u003e[12,24]\u003c/sup\u003e\u003c/em\u003e, whereas 45XO is more common under the age of 35. Ozawa et al\u003cem\u003e\u003csup\u003e[17]\u0026nbsp;\u003c/sup\u003e\u003c/em\u003ealso previously found that chromosomal abnormality rates for trophoblasts were higher for older (≥35 years) as compared to younger (\u0026lt; 35 years) women (70.59% vs. 51.48%), with autosomal trisomy rates rising with age, particularly in the case of trisomy 15 and 21. Rates of 45XO and CNV detection also declined with maternal age, while triploidy/multiploidy was more commonly detected among patients \u0026lt;34 years, declining sharply at ages above 35. Double/multiple trisomy rates also rose with age, thus supporting a model in which CNVs, sex chromosome abnormalities, and triploidy/multiploidy are more likely to impact women at a younger age, whereas double/multiple trisomies have greater odds of manifesting in women ≥35 years of age\u0026nbsp;\u003cem\u003e\u003csup\u003e[12,17]\u003c/sup\u003e\u003c/em\u003e. These differences may be attributable to the dynamics of chromosomal recombination, which tends to decline with age, resulting in a reduction in chromosomal segregation\u0026nbsp;\u003cem\u003e\u003csup\u003e[25]\u003c/sup\u003e\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003eWhile maternal age is known to be closely associated with recombination rate, the corresponding effects of paternal age are less clear. This distinction is related to the sex-specific meiotic duration, timing, and outcomes\u0026nbsp;\u003cem\u003e\u003csup\u003e[26]\u003c/sup\u003e\u003c/em\u003e. Triploidy is a consequence of improper ploidy at the time of fertilization, which can arise from fertilization by two sperm or two eggs\u0026nbsp;\u003cem\u003e\u003csup\u003e[27]\u003c/sup\u003e\u003c/em\u003e. Sex chromosome monosomies are generally the result of the loss of the paternal X or Y chromosome, and they also present with a reverse age effect. One study previously demonstrated that the X chromosome source is related to maternal age, such that the average maternal age in the 45,XP group with a single X chromosome from the paternal side was significantly lower than that in the 45,Xm group with a single X chromosome from the maternal side\u003cem\u003e\u003csup\u003e[28]\u003c/sup\u003e\u003c/em\u003e.\u003c/p\u003e\n\u003cp\u003eDespite the strong evidence that advanced maternal age is related to the occurrence of trisomies and other chromosomal abnormalities and its status as an independent risk factor associated with miscarriage, the mechanistic basis for this relationship remains unclear. Ovarian reserve and function trend downward with age. To determine whether these changes may be associated with embryonic chromosomal abnormalities, correlations with ovarian reserve were thus examined at length. Serum AMH levels are positively correlated with ovarian reactivity in women of various ages\u003cem\u003e\u003csup\u003e[29]\u003c/sup\u003e\u003c/em\u003e, and both age and levels of AMH are related to miscarriage risk\u003cem\u003e\u003csup\u003e[30]\u003c/sup\u003e\u003c/em\u003e. Clinical pregnancy rates and live birth rates for women with higher AMH levels tend to be lower, with a corresponding rise in the rate of miscarriage\u0026nbsp;\u003cem\u003e\u003csup\u003e[31]\u003c/sup\u003e\u003c/em\u003e. AMH levels were thus leveraged as an index for ovarian reserve function in this study\u0026nbsp;\u003cem\u003e\u003csup\u003e[32]\u003c/sup\u003e\u003c/em\u003e. When specifically focusing on patients who had undergone AMH testing within the past year, a decrease in ovarian reserve function was found to be associated with a gradual rise in the rate of chromosomal abnormality detection. Given the independent association between age and chromosomal abnormalities, age-stratified analyses were performed, revealing that the chromosomal abnormality detection rate continued to rise with declining ovarian reserve function among both younger and older women. CNV, 45XO, and triploidy/multiploidy detection became less frequent with declining ovarian reserve, whereas the opposite was true for trisomy detection. These trends aligned well with age-related trends, further supporting a link between reduced ovarian reserve function and the incidence of chromosomal abnormalities. Shahine et al.\u0026nbsp;\u003cem\u003e\u003csup\u003e[33]\u003c/sup\u003e\u003c/em\u003e found that relative to patients with normal ovarian reserve function who experienced unexplained recurrent spontaneous abortion (RSA), those with declining ovarian reserve function who experienced RSA exhibited higher rates of embryonic aneuploidy.\u0026nbsp;In this study,\u0026nbsp;A higher proportion of aneuploid chromosomes was observed among women exhibiting declining ovarian reserve function (57% vs. 49%), with this difference having been most pronounced among women \u0026lt; 38 years of age (67% vs. 53%).\u0026nbsp;The present study aligns well with these prior results. Limitations of these analyses include the smaller sample size, the fact that ovarian reserve function was only assessed using a single index, and the absence of any corresponding analyses of paternal age, however. Shahine\u003cem\u003e\u003csup\u003e[33]\u003c/sup\u003e\u003c/em\u003e suggested that, compared to unexplained recurrent spontaneous abortion (RSA) patients with normal ovarian reserve function, unexplained RSA patients with declining ovarian reserve function have a higher incidence of aneuploid chromosomal abnormalities in embryos. Women with declining ovarian reserve function have a higher proportion of aneuploid chromosomes (57% vs. 49%), and this difference is more significant in patients under 38 years of age (67% vs. 53%). Our study aligns with the findings of Shahine's research. The limitations of this study include a small sample size, the need for further analysis with a larger sample, the use of a single indicator for assessing ovarian reserve function, and the lack of analysis of paternal age.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eThe Relationship Between Chromosomal Abnormalities and ART\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHow ART relates to the incidence of embryonic chromosomal abnormalities has been a matter of some controversy. In some reports, ART was found to have no effect on such abnormalities\u0026nbsp;\u003cem\u003e\u003csup\u003e[34-35]\u003c/sup\u003e\u003c/em\u003e\u003cem\u003e,\u003c/em\u003e although others have described higher rates of chromosomal structural abnormalities for patients undergoing ART (13.2% vs. 4.2%, P \u0026lt; 0.05)\u003csup\u003e[10]\u003c/sup\u003e. With respect to the types of embryo transfer protocols employed, chromosomal abnormality rates are reportedly lower in cases of frozen embryo or frozen blastocyst transfer\u0026nbsp;\u003cem\u003e\u003csup\u003e[36]\u003c/sup\u003e\u003c/em\u003e. Deletions and microdeletions are reportedly more common in cases of intracytoplasmic sperm injection (ICSI) as compared to \u003cem\u003ein vitro\u0026nbsp;\u003c/em\u003efertilization and embryo transfer(IVF-ET) protocols. The utilization of frozen embryos has been suggested to help protect developing embryos from the adverse effects of exposure to an estrogen-rich environment\u003cem\u003e\u003csup\u003e[10]\u003c/sup\u003e\u003c/em\u003e\u003cem\u003e.\u003c/em\u003e Some studies, however, have argued that ART can contribute to a greater risk of embryo chromosomal abnormalities and miscarriage\u0026nbsp;\u003cem\u003e\u003csup\u003e[37]\u003c/sup\u003e\u003c/em\u003e. While the general types of chromosomal abnormalities in cases of ART may be similar to those for natural conception\u003cem\u003e\u003csup\u003e[9]\u003c/sup\u003e\u003c/em\u003e, particular ART techniques also have the potential to preferentially give rise to certain abnormalities. ICSI, for instance, is linked to a greater risk of non-disjunction abnormalities, higher X monosomy rates\u0026nbsp;\u003cem\u003e\u003csup\u003e[38]\u003c/sup\u003e\u003c/em\u003e, and lower polyploidy rates\u0026nbsp;\u003cem\u003e\u003csup\u003e[39]\u003c/sup\u003e\u003c/em\u003e. Kim et al.\u003cem\u003e\u003csup\u003e[40]\u003c/sup\u003e\u003c/em\u003e reported that aside from a higher rate of sex chromosome abnormalities among patients undergoing ICSI in cases of male factor infertility, ART was not linked to any greater odds of chromosomal abnormalities. The differences that do exist also have the potential to be a consequence of parental factors, rather than any risks unique to the procedure of ICSI itself.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHere, a higher rate of trisomy detection was observed in the ART group, whereas CNV and triploidy/multiploidy detection rates were higher in the NC group. These trends remained intact when stratified according to age, supporting a link between ART and changes in the incidence of trisomies. ART has been reported to increase the risk of chromosomal numerical abnormalities, particularly in cases of trisomies\u003cem\u003e\u003csup\u003e[9]\u003c/sup\u003e\u003c/em\u003e. One limitation of these analyses is that no effort was made to distinguish between different ART protocols when assessing chromosomal abnormality rates, underscoring a need for further studies aimed at clarifying the relationships between ART and these outcomes in order to guide the development of more optimal ART strategies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.5 The Link Between Prior Natural Miscarriages and Chromosomal Abnormalities\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRecurrent spontaneous abortion(RSA) is a term used to refer to instances of two or more miscarriages. More than half of women experience at least one miscarriage in their lifetime, and this proportion rises among women 35+ years of age, but \u0026lt; 1% of women experience\u0026nbsp;three consecutive natural miscarriages\u0026nbsp;\u003cem\u003e\u003csup\u003e[41]\u003c/sup\u003e\u003c/em\u003e. These recurrent miscarriages can be physically and emotionally taxing for couples such that efforts to improve pregnancy outcomes for RSA patients are desperately needed. Efforts to clarify the etiological basis for RSA are vital for the appropriate evaluation and targeted treatment of pregnancies for couples with a history of RSA.\u003c/p\u003e\n\u003cp\u003eEmbryonic chromosomal abnormalities are in 64.8% of all cases of spontaneous abortion, whereas these abnormalities are only evident in 3.9% of\u0026nbsp;unnaturally aborted embryos \u003cem\u003e\u003csup\u003e[9]\u003c/sup\u003e\u003c/em\u003e. An estimated 76.2% of patients first found to exhibit embryonic chromosomal abnormalities have subsequent embryos with abnormal chromosomes\u0026nbsp;\u003cem\u003e\u003csup\u003e[42]\u003c/sup\u003e\u003c/em\u003e\u003cem\u003e.\u003c/em\u003e A history of prior miscarriages may be linked to greater odds of embryonic chromosomal abnormalities\u003cem\u003e\u0026nbsp;\u003csup\u003e[9]\u003c/sup\u003e\u003c/em\u003e, owing either to abnormalities in the sperm or eggs themselves or to the effects of external environmental factors during the early stages of pregnancy\u0026nbsp;\u003cem\u003e\u003csup\u003e[43-44]\u003c/sup\u003e\u003c/em\u003e. As these same factors are also relevant across multiple pregnancies, any previous diagnoses of embryo karyotypic abnormalities are considered indicative of a greater risk of subsequent miscarriage\u0026nbsp;\u003cem\u003e\u003csup\u003e[45]\u003c/sup\u003e\u003c/em\u003e. Embryogenetic testing is thus often recommended in cases of retained miscarriages in order to provide more information for future pregnancies. Some studies, however, contradict this and indicate that a history of prior miscarriage is not linked to greater odds of detecting embryonic chromosomal abnormalities. One meta-analysis of 55 studies published since 2000 reported no differences in embryonic chromosomal abnormality rates when comparing sporadic and recurrent miscarriages (46%, 95% CI: 39-53 vs. 46%, 95% CI: 39-52)\u0026nbsp;\u003cem\u003e\u003csup\u003e[46]\u003c/sup\u003e\u003c/em\u003e. However, significantly higher rates of sex chromosome and structural abnormalities are evident in cases of sporadic miscarriage relative to recurrent miscarriage\u003cem\u003e\u003csup\u003e[10, 12]\u003c/sup\u003e\u003c/em\u003e. As the number of miscarriages increases, some studies have suggested that the odds of chromosomal abnormalities decrease such that they are detected less frequently in cases of RSA\u003cem\u003e\u003csup\u003e\u0026nbsp;[47]\u003c/sup\u003e\u003c/em\u003e. Indeed, women with a history of ≥ 2 miscarriages exhibit significantly lower rates of chromosomal abnormalities relative to those with a history of \u0026lt; 2 miscarriages,\u0026nbsp;and viable trisomy seemed to be the main contributor\u0026nbsp;to this trend\u003cem\u003e\u003csup\u003e[17]\u003c/sup\u003e\u003c/em\u003e. Here, no significant increase in the frequency of embryonic chromosomal abnormalities was detected as a function of the number of prior miscarriages, nor were there any significant differences in abnormal chromosomal distributions across these groups. Miscarriages typically occur in cases where both parents have normal chromosomes. However, in instances where both spouses exhibit chromosomal abnormalities as in the case of balanced translocations and Robertsonian translocations, carriers often appear phenotypically normal and have the potential for reproduction. As chromosomal imbalance affects 50-70% of the gametes and embryos in these cases, this contributes to a greater risk of embryonic chromosomal abnormalities and miscarriages. Couples who suffer a MA in China often seek out peripheral blood chromosomal testing at the hospital. When this leads to the detection of chromosomal abnormalities, some opt for preimplantation genetic testing (PGT), which can provide an avenue to obtain karyotypically normal healthy embryos prior to implantation, contributing to better pregnancy outcomes.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eEmbryonic chromosomal abnormalities are the leading cause of MAs during the early stages of pregnancy. The present results regarding the types and detection rates for different chromosomal abnormalities in cases of MA are in line with other large-scale studies. The developmental potentials of embryos differed based on their karyotype, with the lowest rates of abnormal chromosome detection having been observed in the empty sac group,\u0026nbsp;supporting a limited role for genetic factors in very early miscarriages. It is thus important to emphasize the roles that other factors play in pregnancy loss. The risk of chromosomal abnormalities may also rise as a function of maternal age, the mode of conception, and declining ovarian reserve. Advanced age, in particular, is associated with a high risk of embryonic chromosomal abnormalities, particularly instances of autosomal trisomy, while CNVs, 45XO, and triploidy/polyploidy may manifest more frequently with younger maternal age. Declining ovarian reserve coincides with higher rates of detection for chromosomal abnormalities, and the distribution of types of abnormalities as a function of ovarian reserve is similar to the observed age-related distribution. Older women and those with declining ovarian reserve may thus benefit from PGT and prenatal diagnostic analyses. The higher rate of autosomal trisomy in the ART group also emphasizes the need to be attentive to the safety of ART for offspring.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAMH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eanti-M\u0026uuml;llerian hormone\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eART\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eassisted reproductive technology\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCNVs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCopy number variations\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCNV-seq\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ecopy number variation sequencing\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eICSI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eintracytoplasmic sperm injection\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIVF-ET\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003e \u003cem\u003ein vitro\u003c/em\u003e fertilization and embryo transfer\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMissed abortion\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003enatural conception\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePGS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePreimplantation Genetic Screening\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePGT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003epreimplantation genetic testing\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRSA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRecurrent spontaneous abortion\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors wish to thank the participants,\u0026nbsp;Jiangxi Maternal and Child Health Hospital\u0026nbsp;hospital staf, and whoever contributed to this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConception/design: Shuhui Huang.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eProvision of study material or patients: Shuhui Huang;Danping Liu; Yongyi Zou\u003c/p\u003e\n\u003cp\u003eCollection and/or assembly of data: Shuhui Huang,\u0026nbsp;Xiaoqing Chen; Huizhen Yuan\u003c/p\u003e\n\u003cp\u003eData analysis and interpretation: Shuhui Huang, Baitao Zeng;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eManuscript writing: Shuhui Huang;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eManuscript revision: Guiqin Bai.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFinal approval of manuscript: All authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work is supported by grants from the\u0026nbsp;Science and technology support plan of Health commission of jiangxi province(Nos.220210887),\u0026nbsp;The funder,\u0026nbsp;Shuhui Huang\u0026nbsp;was responsible for the article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data that support the fndings of this study were available from the cor‑responding author via E-mail due to appropriate request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDue to the retrospective nature of the study, informed consent was waived, but this study was granted by the Medical Ethics Committee of Jiangxi Maternal and Child Health Hospital\u0026nbsp;and the ethics approval number was\u0026nbsp;EC-KY-202011.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eKolte AM, Bernardi LA, Christiansen OB, et al. 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Correlation between chromosomal distribution and embryonic findings on ultrasound in early pregnancy loss after IVF-embryo transfer. Hum Reprod. 2016;31(10):2212-2218. doi:10.1093/humrep/dew201.\u003c/li\u003e\n \u003cli\u003eGoldstein SR, Kerenyi T, Scher J, Papp C. Correlation between karyotype and ultrasound findings in patients with failed early pregnancy. Ultrasound Obstet Gynecol. 1996;8(5):314-317. doi:10.1046/j.1469-0705.1996.08050314.x\u003c/li\u003e\n \u003cli\u003eHassold T, Hunt P. Maternal age and chromosomally abnormal pregnancies: what we know and what we wish we knew. Curr Opin Pediatr. 2009;21(6):703-708. doi:10.1097/MOP.0b013e328332c6ab\u003c/li\u003e\n \u003cli\u003eDai R, Li L, Zhu H, Geng D, Deng S, Liu R. Effect of maternal age on spontaneous abortion during the first trimester in Northeast China. J Matern Fetal Neonatal Med. 2018;31(14):1824-1829. doi:10.1080/14767058.2017.1330330.\u003c/li\u003e\n \u003cli\u003eFan L, Wu J, Wu Y, et al. Analysis of Chromosomal Copy Number in First-Trimester Pregnancy Loss Using Next-Generation Sequencing. Front Genet. 2020;11:545856. Published 2020 Oct 20. doi:10.3389/fgene.2020.545856.\u003c/li\u003e\n \u003cli\u003eHenderson SA, Edwards RG. Chiasma frequency and maternal age in mammals. Nature. 1968;218(5136):22-28. doi:10.1038/218022a0.\u003c/li\u003e\n \u003cli\u003eHussin J, Roy-Gagnon MH, Gendron R, Andelfinger G, Awadalla P. Age-dependent recombination rates in human pedigrees. PLoS Genet. 2011;7(9):e1002251. doi:10.1371/journal.pgen.1002251.\u003c/li\u003e\n \u003cli\u003eMarton T, Hargitai B, Patk\u0026oacute;s P, Csap\u0026oacute;\u0026nbsp;Z, Szende B, Papp Z. A fetopathologiai feldolgoz\u0026aacute;s gyakorlata [Practice of fetal pathological examination]. Orv Hetil. 1999;140(25):1411-1416..\u003c/li\u003e\n \u003cli\u003eHassold T, Benham F, Leppert M. Cytogenetic and molecular analysis of sex-chromosome monosomy. Am J Hum Genet. 1988;42(4):534-541.\u003c/li\u003e\n \u003cli\u003eFerraretti AP, La Marca A, Fauser BC, et al. ESHRE consensus on the definition of \u0026apos;poor response\u0026apos; to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011;26(7):1616-1624. doi:10.1093/humrep/der092.\u003c/li\u003e\n \u003cli\u003eZhang B, Meng Y, Jiang X, et al. IVF outcomes of women with discrepancies between age and serum anti-M\u0026uuml;llerian hormone levels. Reprod Biol Endocrinol. 2019;17(1):58. Published 2019 Jul 16. doi:10.1186/s12958-019-0498-3.\u003c/li\u003e\n \u003cli\u003eDuncan FE, Jasti S, Paulson A, Kelsh JM, Fegley B, Gerton JL. Age-associated dysregulation of protein metabolism in the mammalian oocyte. Aging Cell. 2017;16(6):1381-1393. doi:10.1111/acel.12676.\u003c/li\u003e\n \u003cli\u003eDewailly D, Laven J. AMH as the primary marker for fertility. Eur J Endocrinol. 2019;181(6):D45-D51. doi:10.1530/EJE-19-0373.\u003c/li\u003e\n \u003cli\u003eShahine LK, Marshall L, Lamb JD, Hickok LR. Higher rates of aneuploidy in blastocysts and higher risk of no embryo transfer in recurrent pregnancy loss patients with diminished ovarian reserve undergoing in vitro fertilization. Fertil Steril. 2016;106(5):1124-1128. doi:10.1016/j.fertnstert.2016.06.016.\u003c/li\u003e\n \u003cli\u003ePylyp LY, Spynenko LO, Verhoglyad NV, Mishenko AO, Mykytenko DO, Zukin VD. Chromosomal abnormalities in products of conception of first-trimester miscarriages detected by conventional cytogenetic analysis: a review of 1000 cases. J Assist Reprod Genet. 2018;35(2):265-271. doi:10.1007/s10815-017-1069-1.\u003c/li\u003e\n \u003cli\u003eLi G, Jin H, Niu W, et al. Effect of assisted reproductive technology on the molecular karyotype of missed abortion tissues. Biosci Rep. 2018;38(5):BSR20180605. Published 2018 Oct 17. doi:10.1042/BSR20180605.\u003c/li\u003e\n \u003cli\u003eLi J, Zhang F, Sun B, et al. Lower chromosomal abnormality frequencies in miscarried conceptuses from frozen blastocyst transfers in ART. Hum Reprod. 2021;36(4):1146-1156. doi:10.1093/humrep/deaa352.\u003c/li\u003e\n \u003cli\u003eCampos-Galindo I, Garc\u0026iacute;a-Herrero S, Mart\u0026iacute;nez-Conejero JA, Ferro J, Sim\u0026oacute;n C, Rubio C. Molecular analysis of products of conception obtained by hysteroembryoscopy from infertile couples. J Assist Reprod Genet. 2015;32(5):839-848. doi:10.1007/s10815-015-0460-z.\u003c/li\u003e\n \u003cli\u003eLathi RB, Milki AA. Rate of aneuploidy in miscarriages following in vitro fertilization and intracytoplasmic sperm injection. Fertil Steril. 2004;81(5):1270-1272. doi:10.1016/j.fertnstert.2003.09.065.\u003c/li\u003e\n \u003cli\u003eMart\u0026iacute;nez MC, M\u0026eacute;ndez C, Ferro J, Nicol\u0026aacute;s M, Serra V, Landeras J. Cytogenetic analysis of early nonviable pregnancies after assisted reproduction treatment. Fertil Steril. 2010;93(1):289-292. doi:10.1016/j.fertnstert.2009.07.989.\u003c/li\u003e\n \u003cli\u003eKim JW, Lee WS, Yoon TK, et al. Chromosomal abnormalities in spontaneous abortion after assisted reproductive treatment. BMC Med Genet. 2010;11:153. Published 2010 Nov 3. doi:10.1186/1471-2350-11-153.\u003c/li\u003e\n \u003cli\u003eBranch DW, Gibson M, Silver RM. Clinical practice. Recurrent miscarriage. N Engl J Med. 2010;363(18):1740-1747. doi:10.1056/NEJMcp1005330.\u003c/li\u003e\n \u003cli\u003eSugiura-Ogasawara M, Ozaki Y, Katano K, Suzumori N, Kitaori T, Mizutani E. Abnormal embryonic karyotype is the most frequent cause of recurrent miscarriage. Hum Reprod. 2012;27(8):2297-2303. doi:10.1093/humrep/des179.\u003c/li\u003e\n \u003cli\u003eShen JD, Sun FX, Qu DY, et al. Zhonghua Fu Chan Ke Za Zhi. 2019;54(12):797-802. doi:10.3760/cma.j.issn.0529-567x.2019.12.002.\u003c/li\u003e\n \u003cli\u003eWang W, Shao S, Chen W, et al. Electrofusion Stimulation Is an Independent Factor of Chromosome Abnormality in Mice Oocytes Reconstructed via Spindle Transfer. Front Endocrinol (Lausanne). 2021;12:705837. Published 2021 Jul 28. doi:10.3389/fendo.2021.705837\u003c/li\u003e\n \u003cli\u003evan den Berg MM, van Maarle MC, van Wely M, Goddijn M. Genetics of early miscarriage. Biochim Biophys Acta. 2012;1822(12):1951-1959. doi:10.1016/j.bbadis.2012.07.001.\u003c/li\u003e\n \u003cli\u003eSmits MAJ, van Maarle M, Hamer G, Mastenbroek S, Goddijn M, van Wely M. Cytogenetic testing of pregnancy loss tissue: a meta-analysis. Reprod Biomed Online. 2020;40(6):867-879. doi:10.1016/j.rbmo.2020.02.001．\u003c/li\u003e\n \u003cli\u003eSakamoto A, Kamada Y, Kubo K, et al. Slow Fetal Heart Rate before Miscarriage in the Early First Trimester Predicts Fetal Aneuploidy in Women with Recurrent Pregnancy Loss. Acta Med Okayama. 2018;72(1):61-66. doi:10.18926/AMO/55664.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Table","content":"\u003cp\u003eTable 2 is not available with this version\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"missed abortion, CNV-seq, Chromosome abnormality, Maternal age, Pregnancy mode；AMH；Embryonic/fetal size, Number of abortions；","lastPublishedDoi":"10.21203/rs.3.rs-4641482/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4641482/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e This study was developed as a retrospective analysis of the rates of embryonic chromosomal abnormalities in cases of missed miscarriages during early pregnancy, with a focus on identifying associated factors as a means of clarifying the genetic basis for missed miscarriages and how this pregnancy outcome relates to a variety of clinical and demographic characteristics.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: The present study enrolled 1490 patients who had been diagnosed with missed miscarriage and underwent CNV-seq testing at the Jiangxi Maternal and Child Health Hospital from January 2020 through December 2022. Medical records were accessed to obtain clinical data pertaining to these miscarriage cases, and the results of chromosomal abnormality testing were analyzed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eChromosomal abnormalities were detected in 63.76% of all missed miscarriages, and included instances of autosomal trisomy (68.38%), triploidy/polyploidy (11.68%), 45XO (10.84%), CNVs (8.84%), double/multiple trisomy (4.32%), sex chromosome trisomy/polyploidy (0.32%), and complex abnormalities (2.95%). An examination of the relationship between these chromosomal abnormalities and clinical characteristics revealed that chromosomal abnormality incidence rates were significantly related to maternal age, mode of conception, AMH levels, and the presence or absence of an embryonic/fetal heartbeat. Advanced maternal age, mode of conception, and lower AMH levels were associated with a greater risk of embryonic chromosomal abnormalities. Specifically, the rates of autosomal trisomy gradually rose with maternal age (P\u0026lt;0.05), whereas 45XO, CNVs, and triploidy/polyploidy detection rates declined with age (P\u0026lt;0.05). Declining ovarian reserve function was associated with higher rates of karyotypic abnormalities (P\u0026lt;0.05). Higher rates of karyotypic abnormalities were also evident in the natural conception (NC) group, as were rates of CNVs and trisomy/polyploidy (P \u0026lt; 0.01), whereas higher rates of autosomal trisomy were detected in the assisted reproductive technology (ART) group. No relationship between a history of spontaneous miscarriages and the incidence of embryonic chromosomal abnormalities was detected.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eEmbryonic chromosomal abnormalities are the leading cause of early missed miscarriages. The present results indicate that advanced maternal age, declining ovarian reserve function, and mode of conception can all increase the risk of these chromosomal abnormalities. Age and the presence of a fetal/embryonic heartbeat may be related to the incidence of different types of chromosomal abnormalities, while a history of prior missed miscarriages is not related to the odds of embryonic chromosomal abnormalities.\u003c/p\u003e","manuscriptTitle":"Evaluating the link between chromosomal abnormalities and diminished ovarian reserve, mode of conception, and history of prior miscarriages in cases of early missed abortion using CNV-seq","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-26 17:12:11","doi":"10.21203/rs.3.rs-4641482/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-17T13:21:34+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-11T18:50:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"242726968021268830882475836345071974818","date":"2025-05-29T08:41:28+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-12T17:41:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"253414747514341759747082341866369146166","date":"2025-05-02T08:04:12+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-09-16T08:15:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"311696595245020488684757337160655477417","date":"2024-09-04T02:04:52+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-08-14T14:14:01+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-06-28T18:30:10+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-06-26T23:31:24+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-06-26T23:29:26+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2024-06-26T09:11:39+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0ec87e17-0f5f-4de6-a4e1-c869d6d5dc4f","owner":[],"postedDate":"July 26th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-15T16:00:43+00:00","versionOfRecord":{"articleIdentity":"rs-4641482","link":"https://doi.org/10.1186/s12884-025-08562-4","journal":{"identity":"bmc-pregnancy-and-childbirth","isVorOnly":false,"title":"BMC Pregnancy and Childbirth"},"publishedOn":"2025-12-09 15:57:16","publishedOnDateReadable":"December 9th, 2025"},"versionCreatedAt":"2024-07-26 17:12:11","video":"","vorDoi":"10.1186/s12884-025-08562-4","vorDoiUrl":"https://doi.org/10.1186/s12884-025-08562-4","workflowStages":[]},"version":"v1","identity":"rs-4641482","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4641482","identity":"rs-4641482","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}
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