Question

Write a 4 paragraph journal critique for the article, not too long but not too short also.

TITLE: The Frequency of Chromosomal Abnormalities in Individuals with Susceptibility to Abortion and/or Infertility by Cytogenetics Method

Clinically, abortion is defined as the termination of pregnancy before the 18th to 20th week of pregnancy, with an embryo weighing less than 500 grams [1]. Also, Recurrent abortion or recurrent pregnancy loss (RLP) is defined as; is three or more consecutive pregnancy losses prior to 20 weeks from the last menstrual period. Studies strongly suggest that in fertile couples (infertility is: the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse), pregnancy occurs in at least 60% of normal cycles. Studies also suggest that 50% of these fertility end in the uterus before implantation. The ending date for pregnancy is about 30% shortly after implantation (before the clinical diagnosis of pregnancy), even after clinical diagnosis of pregnancy, 25% of pregnancies usually end in abortion during the first 14 weeks. The most dangerous time is between 6 and 8 weeks after the last menstrual period, with more than 50% of aborted foetuses at this time having chromosomal problems [2-5]. In fact, more than 80% of abortions occur in the first 12 weeks of pregnancy, and chromosomal abnormalities are at least responsible for 50% of them. After the first trimester, abortion rates and incidence of chromosomal abnormalities decrease [3]. Chromosomal abnormalities may occur due to structural disturbances and the displacement of chromosomal fragments in the parent chromosomes or disruptions in the number of embryo chromosomes. Parental chromosomal complexation in 2-3% is abnormal abortion, usually due to chromosomal displacement, chromosome reversal, ringing, and chromosomal microscopy [4-8]. The rate of abortion is 30% immediately after implantation (before the pregnancy is clinically diagnosed). Even after having a pregnancy diagnosed clinically, about a quarter of pregnancies are aborted, which usually occurs within the first 14 weeks. The most dangerous time between weeks 6 and 8 is from the last menstruation. Half of the babies aborting at this time have a chromosomal abnormality. Birth defects have been observed in 3% of the live births, with a significant proportion of these defects (20%) related to chromosomal abnormalities or gene mutations. Some of the aneuploidy, including anioplose, 13, 18, 21, X, and Y chromosomes can lead to the birth of the baby alive and abnormal [9-14]. These disorders do not pose a problem for the parents themselves, but make it difficult to divide and create male and female sex cells in the ganglion. These disorders are detectable by performing a karyotype test. Therefore, abnormal karyotype in any of the couples can be a source of infertility or frequent abortion. In the present study, the prevalence of chromosomal abnormalities in these couples in the western province of is to examine the importance of testing the pre-pregnancy and even marriage karyotype awareness.

A cytogenetic study was performed on 200 individuals (124 women (28.1 ± 5) and 76 males (30.7 ± 5) with infertility and/or abortion with age average 30.81 ± 5 using lymphocyte culture and high-resolution G-banding method.

Normal karyotype and various types of chromosomal abnormalities were observed in 138 (69%) and 62 (31%) individuals, respectively. Also, the frequency of translocations, insertions, deletions, inversions and duplications were 40.32% (25), 22.6% (14), 17.74% (11), 9.7% (6) and 9.7% (6) respectively, that the highest frequency was related to changes in transposition or chromosomal displacement with 25 cases (40.3%) In addition, the types of chromosomal abnormalities involving translocations, insertions, deletions, inversions and duplications were detected in 15, 9, 6, 3 and 2 persons, respectively, from 35 patients with RLP and 10, 5, 5, 3 and 4 persons, respectively, of 27 patients with infertility.

This issue can also play a role in the planning of pregnant mother’s health.

Answer 1

Chromosomal Abnormalities Causes Miscarriages

Chromosomal abnormalities are a random occurrence, but very common in women over 35 years. Chromosomal abnormalities occur due to various reasons out of which only 5% are genetic.

An abnormal sperm, abnormal egg, an improper fertilization and exposure to toxic environmental factors can be a potent cause of chromosomal abnormalities. There are two types of chromosomal abnormalities that result in miscarriages

Embryo Chromosomal Abnormalities

Majority of miscarriages are an outcome of unnaturalness of a number of chromosomes in the embryo. Sometimes, embryos have a pair of chromosomes that are either more than or less than 23 (actual no.) thus, becoming vulnerable to miscarriage. Due to chromosomal abnormalities, the embryo may not be able to develop properly and its survival in the womb may end. Sadly, there is no treatment preventing the development of chromosomal abnormalities in the embryo. It is not necessary that all embryos with chromosomal unnaturalness will end up in miscarriage. Few can reach delivery, but such babies are born with some birth defects. Types of chromosomal abnormalities in embryos include:

• Nullisomy: It occurs when an embryo is missing a pair of chromosome. Nullisomic embryos do not survive thereby, ending in miscarriages.
• Monosomy: This occurs when one chromosome of the foetus lacks its homolog. Monosomies do not survive and if at all they do survive, they have a number of birth defects such as Down syndrome or do not live for longer than a few days or weeks.
• Trisomy: This occurs when one extra copy of a chromosome is present in the foetus. Trisomies have few chances of survival. Most trisomies are born with Down syndrome. They have distinct facial features, altered body shape and short stature.
• Tetrasomy: It is a rare case and occurs when a total of four chromosome pairs are present.
• In pregnancy through IVF process, chromosomal abnormalities can be identified using pre-implantation genetic diagnosis. No matter what the cause is, a miscarriage is always painful and emotionally devastating.

• Parental Chromosomal Abnormalities

  Miscarriages due to parental chromosomal unnaturalness are rare. In this form of abnormality, one of the parents has some abnormality in his/her chromosomes. Also known as translocation abnormality, the chromosome of any parent (say chromosome 15) changes or swaps its place with another chromosome (say chromosome 23). Such parents can have a completely normal baby. A baby born with same chromosomal pattern or a foetus with chromosomal abnormalities will result in miscarriage.
  
  
  Nothing can be done to prevent chromosomal abnormalities in your embryos, but to alleviate the chances of miscarriage due to chromosomal unnaturalness, take the adequate nutrition. Consult your doctor to increase the consumption of folic acid, which is helpful in preventing chromosomal abnormalities.

• Recurrent Miscarriage and Chromosomal Abnormalities

  According to the Oxford Journal, Human Reproduction, “Chromosomal abnormalities are an important cause of spontaneous abortion and recurrent miscarriage (RM).” Genetic problems in an embryo increase the chances of repeated miscarriage by 3 per cent to 5 per cent. The pregnancy naturally terminates in its early stages. According to the Textbook of Gynaecology by Kamini A Rao, chromosomal abnormalities are the direct cause of spontaneous abortion and autosomal trisomy, polypliodi and monosomy X are most commonly found abnormality in cases of recurrent miscarriage.

• Fruits to Avoid During Pregnancy

Pregnancy is the most delicate period for a woman and for her unborn baby. A pregnant woman should be very careful during pregnancy to ensure proper health of the unborn baby. If you are pregnant it is important that you take extra care while choosing everything that goes into your mouth.

Pregnancy affects your immune system and makes you and your child more susceptible to the bacteria and viruses that cause foodborne illnesses. There are certain fruits that need to be avoided during pregnancy. You want the best for your baby, so, in case you have missed out this instruction, here is a checklist of fruits to avoid during pregnancy. Keep this handy to ensure that you and your unborn baby stay healthy and safe.

Avoid Papaya

Wondering if we can eat papaya during pregnancy? The answer is NO. A lot of women from Sri Lanka, Banladesh, India as well as Pakistan have used papaya as an abortifacient, but it is not something that should worry you unless you binge on it. Papaya intake apparently brings on labour early or causes miscarriage. This is partially true. Papayas, especially the unripe and semi-ripe ones are rich in latex, which is known to trigger uterine contractions.

Green papaya was often applied directly to the uterus, but food forms such as green papaya salad, the seeds of papaya in the parasite killing papaya seed smoothie ahead, as well as supplements containing papain enzyme should be avoided during the third and final trimester of pregnancy. For this reason Papaya is in list of foods to avoid during pregnancy.

However, ripe papayas are excellent during pregnancy. Ripe papayas are rich in vitamins, such as vitamin C and other wholesome nutrients that prevent the onset of pregnancy symptoms, such as heartburn and constipation. Papayas mixed with honey and milk are also an excellent tonic for pregnant women, especially during lactation. Ripe papayas contain much lower levels of papain and are generally considered very healthy for pregnant women with it’s rich antioxidant and vitamin content and many other health benefits.

Avoid Pineapple

Can pregnant women eat Pineapple? The answer is NO. Eating pineapple during pregnancy is not good so resist yourself from consuming pineapple during pregnancy. Pineapples are rich in bromelain, which can cause the softening of the cervix leading to early labour.

One can have pineapple in moderate quantities as it will have no effect on labour and delivery, however, its intake should be restricted during the first trimester to avoid any unforeseen event such as softening of the cervix. For this reason Pineapple is in list of foods to avoid during pregnancy. A lot of women opine that drinking lots of pineapple juice can help them achieve labour. So you must stop yourself and your dear ones from eating pineapple while pregnant.

Avoid Grapes

Can we eat grapes during pregnancy? Answer to this is shrouded in controversy. While some medical professionals suggest that you avoid eating grapes during pregnancy, other advice that you do use it. Most expert advice the former because of the amount of pesticides that are sprayed on grape plants to keep from being eaten away by insects.

Moreoever, the main bone of contention is the high amount of resveratrol present in grapes. This chemical can cause toxicity for the expectant mother. But, eating grapes during pregnancy can also give you vital nutrients like vitamin A and C. So, you need to speak with your doctor before you come to any decision about eating grapes during pregnancy.

Avoid Unwashed Raw Fruits during Pregnancy

The most important advice for pregnant women is to avoid unwashed and unpasteurised fruits during pregnancy. It is critical that food hygiene is given primal importance during pregnancy to avoid infections from toxoplasmosis. Fruits should be an integral part of every pregnancy diet, however, one must exercise caution and avoid eating some of them such as pineapples or papayas in excess, in order to avoid any complication during pregnancy.

Here's the proper way to prepare and handle them safely:

Maternal Age and Chromosomal Abnormalities

The Advanced Fertility Center of Chicago states that, “We do not know exactly why there is an increase in chromosomal abnormalities in the eggs of women as they age. However, research studies have clarified some of the issues involved. The meiotic spindle is a critical component of eggs that is involved in organizing the chromosome pairs so that a proper division of the pairs can occur as the egg is developing. An abnormal spindle can predispose to development of chromosomally abnormal eggs.”
The older women have more chances of having abnormal functioning of chromosome spindles and therefore, are at an increased risk of developing embryo chromosomal abnormalities/problems.

Testing for Chromosomal Abnormalities

Couples who have had recurrent miscarriages are advised to undergo chromosomal abnormalities to determine the genetic fault in the parents or in the foetus. Foetus’s genetic makeup can be traced using Chromosome Testing on Foetal (Miscarriage) Tissue and parents’ genetic pattern can be tested using Karyotyping of Parents.

Chromosome Testing on Foetal (Miscarriage) Tissue: This test is conducted immediately after the miscarriage has happened. The genetic pattern of the foetus is studied deeply to determine any chromosomal abnormality it had which inhibited its survival in the womb.

Karyotyping of Parents: The chromosomal pattern of blood of both the parents are analysed to determine any genetic problem in the either of them. For better understanding of chromosomal anomaly that caused miscarriage, parents’ genetic pattern is studied in conjunction with foetus’s makeup.  


Chromosomal abnormalities are among the key causes of miscarriage in the first trimester of pregnancy and unfortunately, these cannot be controlled.

• Thoroughly rinse raw fruits and vegetables under running water before eating or preparing them, especially fruits that require peeling or cutting - like cantaloupe and other melons. Bacteria can be found on the outer rind or peel
• Don't use soap, detergents, or bleach solutions to wash produce

• Fruits should comprise a major part of your diet wheny you are pregnant clearly because they are loaded with nutrients. But, it is important for you to alter the list of your favourite fruits for the sake of your baby. Avoid the bad ones, and stay healthy.

• As an added precaution, use a small vegetable brush to remove surface dirt
• Try to cut away damaged or bruised areas - bacteria can thrive in these places