#84 : Should Women Who Had Recurrent Miscarriage be Offered Karyotyping Analysis of the Product of Conception: A Survey of Patients’ View

Abstract

Background and Aims: Recurrent miscarriage (RM) affects 2-3% of couples. Approximately 60% of miscarriages result from fetal aneuploidy. Current international guidelines do not recommend routine genetic analysis of product of conception (POC). Nevertheless, a national survey reported that 78% of women wanted to know the cause of their miscarriage. In addition, a majority of patients thought they had done something wrong, leading to miscarriages. The identification of the cause of their miscarriages may help to reduce their guilty feelings. This study aims to assess women’s views on the karyotyping of the POC to determine if the existing guideline should be amended. Method: Women who attended the Obstetrics and Gynecology outpatient clinic were recruited. They were asked to fill in a questionnaire consisting of 24 questions. Results: A total of 149 women were recruited. The desire to know the karyotype of POC, which was assessed by a 100 mm Visual analogue Scale, was 85.1 ± 24.3 (mean ± SD). 77.6% of women expressed that they wanted to perform karyotyping of POC even though they were informed that there was no apparent beneficial effect of genetic testing of POC on the prognosis. Nevertheless, only 10.7% of women were given the option to check the karyotype. More than one-third of women were willing to spend equal to or more than two thousand Hong Kong dollars on a karyotyping test, which is comparable to the current market price (Figure 1). Conclusion: Our findings suggested that women had a strong desire to know the karyotyping of POC even though they were well informed of the limitation of the karyotype test. To respect and empower our clients, physicians should consider offering the karyotype of POC.