# Reticular

> Canonical references published by Reticular.

- Canonical reference: https://reticular.com/knowledge
- Authority: Reticular first-party reference with recorded publication metadata
- Latest review: 2026-07-13
- Scope: Approved service boundaries and individually published knowledge pages

## Approved service boundaries

### Boundary 1

Reticular information is educational and is not medical advice.

- Claim ID: reticular.operational.educational-only.v1
- Reviewer: John Yang
- Approved: 2026-07-13
- Recheck: 2027-01-13
- Source: [Reticular Terms of Service, Health Data Acknowledgment](https://reticular.com/terms-of-service)

### Boundary 2

Reticular does not choose which embryo to transfer.

- Claim ID: reticular.operational.no-transfer-selection.v1
- Reviewer: John Yang
- Approved: 2026-07-13
- Recheck: 2027-01-13
- Source: [Genetic screening support FAQ](https://reticular.com/genetic-screening-support)

## Canonical knowledge pages

### [Pregnancy Loss Panel: science, value, and evidence](https://reticular.com/knowledge/pregnancy-loss-panel-evidence-and-value)

Reticular's Fertility & Pregnancy Loss Panel investigates a genetic layer that chromosome testing and standard carrier screening may not fully assess: rare parental variants in genes needed for fertility, embryo development, and survival. The peer-reviewed Human Intolerome catalogs 934 viability-associated genes, while a 118-family study found pathogenic or likely pathogenic findings in 21 selected recurrent-euploid-loss families. A credible finding can clarify inheritance and support targeted confirmation, family testing, or reproductive-planning discussions alongside the standard RPL evaluation.

- Release: R2
- Authority: Reticular; The intended use, evidence boundary, and comparison context for Reticular's parent-only pregnancy-loss panel.
- Evidence status: Peer-reviewed biological foundation; product utility still being established
- Review lane: Clinical evidence and interpretation
- Published by: Reticular Team
- Published: 2026-07-13
- Sources: [Pricing and service paths](https://reticular.com/pricing), [Recurrent pregnancy loss: a committee opinion (2026)](https://www.asrm.org/practice-guidance/practice-committee-documents/recurrent-pregnancy-loss-a-committee-opinion-2026/), [Carrier Screening](https://www.acog.org/womens-health/faqs/carrier-screening), [ESHRE guideline: recurrent pregnancy loss](https://www.eshre.eu/-/media/sitecore-files/Guidelines/Recurrent-pregnancy-loss/2022/ESHRE-RPL-Guideline-_-Update-2022_-Final-Version-January-2023_v2.pdf), [The Human Intolerome: a curated database to prioritize genomic variants in stillbirth, pregnancy loss, and neonatal death](https://doi.org/10.1016/j.gim.2026.102546), [Human Intolerome Gene List](https://rpldb.org/intolerome/), [Genetic landscape of human oocyte/embryo defects](https://doi.org/10.1016/j.xgen.2025.101012), [Understanding the genetics of human infertility](https://doi.org/10.1126/science.adf7760), [Genetic Variants in Recurrent Euploid Pregnancy Loss](https://www.medrxiv.org/content/10.1101/2025.10.01.25335660v1)

#### What useful information could the panel add?

The value is not simply a larger gene count. It is the chance to identify a specific inheritance mechanism that changes the questions a family and care team can ask next.

- **Look beyond chromosome count:** A pregnancy or embryo can be euploid and still carry a single-gene variant that disrupts gamete formation, implantation, early development, placental function, or fetal survival. Parent testing examines a layer that karyotyping and PGT-A were not designed to resolve.
- **Clarify an inheritance pattern:** A well-supported finding can distinguish dominant, recessive, X-linked, maternal-effect, or parental-mosaic mechanisms. That can make recurrence counseling more specific than an unexplained-loss label alone.
- **Create a targeted next question:** After clinical confirmation, a pathogenic or likely pathogenic finding may support targeted testing of a partner, relatives, stored pregnancy tissue, or a future pregnancy, depending on the gene and inheritance pattern.
- **Inform reproductive-planning discussions:** Some confirmed findings can support a discussion with a qualified clinician about prenatal diagnosis or PGT-M. Reticular does not provide those procedures, and not every finding creates an actionable option.

#### The science now spans pregnancy loss and recurrent IVF failure

Two research programs show complementary parts of this genetic landscape. A Stanford- and UCSF-led collaboration built the peer-reviewed Human Intolerome for pregnancy loss and developmental viability. A 14-center Chinese study led by Fudan reproductive-genetics researchers analyzed 3,627 selected women with repeated IVF or ICSI failure caused by oocyte or embryo defects. That cohort builds on the field-wide framework Qing Sang, Pierre F. Ray, and Lei Wang synthesized in their 2023 Science review, Understanding the genetics of human infertility.

- **479 of 3,627 selected Chinese IVF/ICSI patients with positive findings:** Chen et al. reported a 13.2% yield across 37 established genes in women under 40 with primary infertility and at least two failed cycles caused by oocyte defects, abnormal fertilization, or embryo arrest. This is not a yield estimate for all IVF patients or for recurrent pregnancy loss.
- **934 viability-associated genes:** The peer-reviewed Human Intolerome catalogs genes associated with miscarriage, stillbirth, neonatal death, or lethality across prenatal and postnatal stages; 59 were linked specifically to first- or second-trimester miscarriage.
- **45 of 566 recessive Intolerome genes represented on the comparison carrier list:** The paper compared its recessive genes with a 112-condition carrier-screening list. The limited overlap supports the idea that the two approaches examine different, though partly overlapping, genetic landscapes.
- **21 of 118 selected families with P/LP findings:** A separate recurrent-euploid-loss study reported pathogenic or likely pathogenic findings in 17.8% of a highly selected research cohort using pregnancy-tissue and parental genome sequencing.
- **25 of 30 research-positive families with inherited findings:** In that same study, most potentially explanatory findings were inherited, which shows why parental genomes can be important even though tissue-based trio analysis remains more informative.

##### Researchers

- [Svetlana A. Yatsenko, MD](https://profiles.stanford.edu/svetlana-yatsenko), Professor of Pathology, Stanford Medicine: First author of the Human Intolerome paper and a senior investigator in reproductive and prenatal genetics.
- [Aleksandar Rajkovic, MD, PhD](https://profiles.ucsf.edu/aleksandar.rajkovic), UCSF Pathology, OB-GYN, and Institute for Human Genetics: Senior author studying the genetic basis of reproductive disorders, pregnancy loss, and human developmental viability.
- [Ruth B. Lathi, MD](https://stanfordhealthcare.org/doctors/l/ruth-lathi.html), Director, Stanford Recurrent Pregnancy Loss Program: Reproductive endocrinologist studying recurrent loss and the clinical utility of genetic testing of miscarriage tissue.
- [Marina Sirota, PhD](https://profiles.ucsf.edu/marina.sirota), Professor and Acting Director, UCSF Bakar Computational Health Sciences Institute: Computational health scientist applying integrative methods to diagnostics and women's health.
- [Qing Sang](https://reprod-genet.fudan.edu.cn/laben/c5/10/c23194a247056/page.htm), Professor, Fudan University Reproduction and Genetics Group: Senior reproductive-genetics investigator in the multicenter oocyte and embryo defects cohort and coauthor of the 2023 Science infertility-genetics review.
- [Lei Wang, PhD](https://reprod-genet.fudan.edu.cn/laben/c5/0f/c23194a247055/page.htm), Professor of Medical Genetics, Fudan University: Lead contact for the multicenter cohort and coauthor of the 2023 Science review, with research focused on genetic mechanisms of oocyte and early embryo development.
- [Pierre F. Ray](https://orcid.org/0000-0003-1544-7449), Université Grenoble Alpes, INSERM, and CNRS: Infertility-genetics researcher and coauthor with Qing Sang and Lei Wang of the 2023 Science review.

These are independent academic researchers whose work Reticular cites. Their authorship does not imply endorsement of Reticular or validation of this specific panel.