Monozygotic twin delivery following reduction from quadramniotic-dichorionic gestation established after ICSI and embryo transfer: Case report

Salim A. Wehbe, Michael J. Tucker, Gianpiero D. Palermo, E. Scott Sills

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

We report the delivery of healthy monozygous (MZ) twins in a 31 year-old nulligravida following gonadotrophin ovulation induction, ICSI, assisted hatching and fresh embryo transfer. Although a sonogram on day 35 confirmed that two of four transferred embryos had implanted, a second transvaginal sonogram 1 week later showed each gestational sac had two conceptuses - all four were associated with distinct amniotic compartments. Cardiac activity was observed in all four embryos. At 12 weeks and 5 days gestation, chorionic villus sampling was performed on fetuses 1 and 2 which were euploid for chromosomes 13, 18, 21, X and Y via fluorescence in-situ hybridization analysis. Subsequent KCl injection into sacs 3 and 4 resulted in asystole for these fetuses, while cardiac activity in sacs 1 and 2 remained unchanged after reduction. A twin vaginal delivery occurred at 36 weeks gestation, resulting in the birth of two male infants and one placenta. This case represents the first known report of human quadruplet pregnancy consisting of two MZ twin sets conceived by assisted reproductive techniques. Our report reviews proposed mechanisms for explaining twinning, with special emphasis on zona pellucida micromanipulation and subsequent MZ twin induction.

Original languageEnglish (US)
Pages (from-to)444-446
Number of pages3
JournalHuman Reproduction
Volume18
Issue number2
DOIs
StatePublished - Feb 1 2003
Externally publishedYes

Fingerprint

Intracytoplasmic Sperm Injections
Monozygotic Twins
Embryo Transfer
Pregnancy
Quadruplet Pregnancy
Fetus
Embryonic Structures
Gestational Sac
Micromanipulation
Chorionic Villi Sampling
Chromosomes, Human, Pair 18
Chromosomes, Human, Pair 13
Zona Pellucida
Assisted Reproductive Techniques
Ovulation Induction
Heart Arrest
Fluorescence In Situ Hybridization
Gonadotropins
Placenta
Parturition

Keywords

  • Delivery
  • IVF
  • Monozygotic
  • Quadramniotic
  • Twins

ASJC Scopus subject areas

  • Physiology
  • Developmental Biology
  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Monozygotic twin delivery following reduction from quadramniotic-dichorionic gestation established after ICSI and embryo transfer : Case report. / Wehbe, Salim A.; Tucker, Michael J.; Palermo, Gianpiero D.; Sills, E. Scott.

In: Human Reproduction, Vol. 18, No. 2, 01.02.2003, p. 444-446.

Research output: Contribution to journalArticle

Wehbe, Salim A. ; Tucker, Michael J. ; Palermo, Gianpiero D. ; Sills, E. Scott. / Monozygotic twin delivery following reduction from quadramniotic-dichorionic gestation established after ICSI and embryo transfer : Case report. In: Human Reproduction. 2003 ; Vol. 18, No. 2. pp. 444-446.
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