Possible structural chromosomal rearrangement requiring karyotype including one of the following:
1. Possible Robertsonian translocation, reciprocal translocation, ring chromosome or other microscopically visible structural rearrangement indicated by findings from microarray, WGS or other laboratory technique.
2. Recurrent miscarriage (defined as three or more consecutive miscarriages) in whom testing of products of conception has not been possible.

Note: this should not be performed routinely nor retrospectively where products of conception have not been provided, but may be used in exceptional circumstances, detailed below;
• Where an attempt to provide pregnancy loss samples has been unsuccessful;
o unsuitable sample (eg. no fetal material/MCC)
o failed sample (eg. fixed in formalin)
• Where the intention has been to collect the next pregnancy loss but this has not been possible due to the nature of the loss
• Five or more biochemical pregnancy losses.

3. A family history suggestive of familial balanced translocation.
4. Unexplained infertility who are going to undergo infertility treatment.
5. Patient with ambiguous genitalia potentially caused by a sex chromosome rearrangement not
detectable via other tests.
6. Egg/sperm donors prior to acceptance.