Infertility Clinical Trial
Official title:
Molecular Associations With Reproductive Failure
The overall hypothesis to be tested is: women with the molecular phenotype of highly skewed X chromosome inactivation are at increased risk of spontaneous abortion.
The overall hypothesis to be tested is: women with the molecular phenotype of highly skewed
X chromosome inactivation are at increased risk of spontaneous abortion.
We will investigate this hypothesis through two complimentary aims. In the Background and
Significance section, we first present data on a 53-member pedigree segregating an X-linked
recessive lethal defect that results in skewed X inactivation in the carrier females via
secondary selection against those cells with the defective X chromosome active. We have
characterized this deletion to be a 500 kb (approximate) deletion in distal Xq28. Moreover,
the carrier females show a statistically significant increase in the frequency of
spontaneous abortion as compared to non-deletion carrying relatives. Secondly, in the
Preliminary Studies section, we present data from a population based case-control study
wherein highly skewed X chromosome inactivation is significantly correlated with idiopathic
recurrent spontaneous abortion. This protocol attempts to elucidate the mechanism underlying
this association.
The first specific aim is to determine if women with highly skewed X chromosome inactivation
are at risk of pregnancy loss. This will be accomplished through a prospective protocol,
analyzing X chromosome inactivation patterns in pregnant women and investigating a possible
association between X chromosome inactivation and pregnancy outcome. The second aim will
study the nature of pregnancy loss in women with skewed X chromosome inactivation. This aim
will correlate maternal X inactivation patterns with abortus karyotype.
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Observational Model: Case Control, Time Perspective: Prospective
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