Authors

Antonia Tocino, M.D., Víctor Blasco, M.Sc., Nicolás Prados, Ph.D., Manuel J. Vargas, M.D., Antonio Requena, Ph.D., Antonio Pellicer, Ph.D., Manuel Fernández-Sánchez, Ph.D.

Volume 103, Issue 5, Pages 1185-1189

Abstract

Objective:

To describe a case of monozygotic twinning with asymmetric development following a single fresh embryo transfer as part of an intracytoplasmic sperm injection (ICSI) treatment. Secondarily, to report the incidence of monozygotic twinning at the IVI (Instituto Valenciano de Infertilidad) clinics.

Design:

Case report.

Setting:

Private fertility centers.

Patient(s):

A 33-year-old woman with a 2-year history of primary infertility.

Intervention(s):

Controlled ovarian hyperstimulation and ICSI treatment with single-embryo transfer.

Main Outcome Measure(s):

Incidence of monozygotic twinning at the IVI clinics.

Result(s):

We report a twin pregnancy after a single-embryo transfer. Twins were dichorionic and diamniotic. One fetus had a 6-day delay in its growth compared with the other when observed by ultrasound. Two female infants were delivered, and despite presenting congenital diseases, they were successfully treated and evolved correctly. A subsequent DNA analysis confirmed that the infants were monozygotic. Furthermore, we estimated a monozygotic twinning rate of 1.17% at the IVI clinics, taking into account those cases in which two or more embryos with heart beats were observed by ultrasound scanning after single-embryo transfers.

Conclusion(s):

Ultrasound scans performed during pregnancy suggested a possible dizygotic origin of the twins, but DNA analysis performed after birth established that they were monozygotic. Genetic analysis is the only valid tool to confirm if like-sex dichorionic twins are monozygotic or dizygotic.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)00080-1/fulltext