BlueCross BlueShield of Tennessee Medical Policy Manual

Chromosomal Microarray Analysis for Evaluation of Pregnancy Loss

Does Not Apply to Commercial Genetic Testing Program effective 6/1/2018


Chromosomal microarray analysis (CMA) of fetal or placental tissue has been proposed as a technique to evaluate the cause of isolated and recurrent early pregnancy loss and intrauterine fetal demise. The evaluation of recurrent and isolated miscarriages and intrauterine fetal demise may involve genetic testing of the products of conception.

Chromosomal microarray analysis can identify submicroscopic genetic abnormalities too small for conventional karyotyping to detect. Because chromosomal microarray analysis does not require dividing cells, it may be useful in the evaluation of fetal demise, in which the culturing of macerated tissue is frequently unsuccessful. In addition, chromosomal microarray analysis is a standardized procedure that involves the use of computerized analysis, whereas karyotyping involves microscopic examination of stained chromosomes and may be more subjective and prone to human error.





American College of Obstetrics and Gynecology. (2016). ACOG Committee on Genetics, Committee Opinion No. 682: Microarrays and next-generation sequencing technology: The use of advanced genetic diagnostic tools in obstetrics and gynecology. Retrieved December 6, 2016 from

American Society for Reproductive Medicine. (2012). Evaluation and treatment of recurrent pregnancy loss: a committee opinion. Retrieved October 13, 2015 from

BlueCross BlueShield Association. Evidence Positioning System. (9:2020). Chromosomal microarray testing for the evaluation of pregnancy loss. (2.04.122). Retrieved April 16, 2021 from (33 articles and/or guidelines reviewed)

Dhillon, R., Hillman, S., Morris, R., McMullan, D., Williams, D., Coomarasamy, A., et al. (2013). Additional information from chromosomal microarray analysis (CMA) over conventional karyotyping when diagnosing chromosomal abnormalities in miscarriage: a systematic review and meta-analysis. British Journal of Obstetrics and Gynaecology, 121 (1), 11-21. (Level 1 evidence)

Levy, B., Sigurjonsson, S., Pettersen, B., Maisenbacher, M.K., Hall, M.P., Demko, Z., et al. (2014). Genomic imbalance in products of conception: single-nucleotide polymorphism chromosomal microarray analysis. Obstetrics and Gynecology, 124 (2 Pt 1), 202-209. Abstract retrieved February 9, 2016 from PubMed database.

Pauta, M., Grande, M., Rodriguez-Revenga, L., Kolomietez, E., & Borrell, A. (2018). Added value of chromosomal microarray analysis over karyotyping in early pregnancy loss: systematic review and meta-analysis. Ultrasound in Obstetrics and Gynecology, 51 (4), 453-462. Abstract retrieved October 16, 2018 from PubMed database.

Popescu, F., Jaslow, C.R., Kutteh, W.H. (2018). Recurrent pregnancy loss evaluation combined with 24-chromosome microarray of miscarriage tissue provides a probable or definite cause of pregnancy loss in over 90% of patients. Hunan Reproduction, 33 (4), 579-587. (Level 4 evidence)

Rosenfeld, J. A., Tucker, M. E., Escobar, L. F., Neill, N. J., Torchia, B. S., McDaniel, L. D., et al. (2015). Diagnostic utility of microarray testing in pregnancy loss. Ultrasound in Obstetrics & Gynecology, 46 (4), 478-486. Abstract retrieved December 6, 2016 from PubMed database.

Sahoo, T., Dzidic, N., Strecker, M., Commander, S., Travis, M., Doherty, C., et al. (2016). Comprehensive genetic analysis of pregnancy loss by chromosomal microarrays: outcomes, benefits, and challenges. Genetics in Medicine, 19 (1), 83-89. Abstract retrieved December 6, 2016 from PubMed database.




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