To the best of our knowledge, this is the first case report of a successful pregnancy and delivery of a healthy infant fathered by an infertile chimera (46, XX/46, XY) following ICSI using frozen testicular sperm.

We report a successful second delivery of a healthy infant fathered using refrozen thawed testicular sperm from an infertile male chimera. We also examined sex chromosome distribution of the seminiferous tubule. Intracytoplasmic sperm injection (ICSI) was performed using the remaining refrozen testicular sperm, which had been stored during the first treatment. Biopsied testicular cells were examined by fluorescence in situ hybridization (FISH) and the peripheral lymphocyte karyotype was tested using a G-band. Following ICSI, a second pregnancy was established, and a healthy girl was successfully delivered at 40 gestational weeks without complications. Although the husband's lymphocyte chromosomal analysis revealed a 46, XX [28]/46, XY [2] karyotype, the seminiferous tubule cells on histological examination by FISH were chimeric sex chromosome type XX [18]/XY [82]. In conclusion, this is a very rare case report of a successful subsequent delivery of a healthy infant (46, XX) from an infertile true hermaphrodite (46, XX/46, XY) using refrozen thawed testicular sperm. The seminiferous tubule cells' karyotype ratio differed from that of the lymphocytes.

Conjoined twins result from an abnormal process in the development of monozygotic twins. The incidence of conjoined twins ranges from 1 in 50,000 to 1 in 100,000 pregnancies [1]. In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) have increased the frequency of multiple pregnancies [2]. The incidence of monozygotic twins is generally constant at one in 250 pregnancies [3]. There were two reports of co njoine d t wi ns w hich occur red af ter assist ed reproductive technology. One case occurred after a combination of IVF and assisted hatching [4]. The other o c c u r r e d a f t e r a c o m b i n a t i o n o f I C S I a n d cryopreservation of embryos [5].In our patient, we performed ICSI and cryopreserved the embryos obtained. Subsequently, we thawed 2 embryos in a natural cycle. After performing assisted hatching, we transferred the embryos. This resulted in a pregnancy, which was determined to be a triplet pregnancy by transvaginal ultrasonography performed a t w e ek 1 0 w e eks ' g est a ti on . A n d a t h or ac oomphalopagus as a conjoined twin was diagnosed in two fetuses. Case ReportA 30-year old gravida 0, para 0 woman underwent her first ICSI with testicular sperm extraction (TESE) in a case involving obstructive azoospermia in the husband. Since spermatozoa could not be obtained from the epidid ymis, TE SE was perf ormed, follow ed by cryopreservation of testicular spermatozoa. From the first day of the treatment cycle, 900 µg of GnRHa (Suprecur, Hoechst) was administered daily (short protocol). Stimulati on was admi nistered in the treatment of menstrual cycles with pure FSH and hMG, with a 10,000 IU dose of hCG administered when the maximum diameter of follicles reached 20 mm. The oocytes were collected 35 hours thereafter. Five oocytes, all grade 1, according to Veeck's classification [ 6 ] , w e r e r e t r i e v e d . I C S I w i t h m o t i l e t h a w e d spermatozoa was performed for all oocytes. All oocytes were successfully fertilized. Three of the 5 oocytes were transferred to the uterus during the treatment cycle. The oocytes, all were grade 1, were transferred at the 7 to 8 cell stage three days after oocyte retrieval. Two oocytes out of 5 were cryopreserved at the 4 cell stage by the slow-freeze method. Finally, none of the transferred oocytes resulted in pregnancy in the first

Purpose Pubertal onset and sexual development are usually normal in 47, XXX individuals; however, we report two cases of premature ovarian failure (POF) in infertile women with trisomy X. Methods Chromosome analysis was conducted with G-banding and fluorescence in situ hybridization using Xand Y-bearing probe. Hormonal administration was primarily Kaufmann's treatment or long-term estradiol treatment, followed by withdrawal bleeding from estrogen and progesterone. Results Two patients with trisomy X, aged 31 (patient 1) and 27 years (patient 2), were diagnosed with POF due to hypergonadotropic hypogonadism. Their ovaries were small. Patient 1 had a FSH level of 44.6 mIU/ml and patient 2 had a FSH level of 74.6 mIU/ml. In patient 1, with Kaufmann's treatment, the FSH decreased to 13.5 mIU/ml; however, follicle growth did not occur following HMG stimulation. In patient 2, FSH did not decrease despite Kaufmann's treatment; therefore, she was given a GnRH agonist and her FSH level decreased to 7.1 mIU/ml. However, her ovaries never responded to HMG stimulation. Conclusion We report on two patients with a 47, XXX karyotype who became infertile due to POF. We recommend that when a patient is diagnosed with trisomy X, the possibility of POF must be strongly considered.

We report two extremely rare cases in which the patients delivered male and female infants that were dizygotic twins (DZT) despite single embryo transfer. : The patient was a 35-year-old woman with a 9-year history of unexplained infertility. In an oocyte retrieval cycle, one blastocyst was transferred; at 26 weeks of gestation, she delivered a 704-g female infant and a 420-g male infant by cesarean section. Because both infants were of extremely low birth weight, they were placed in the neonatal intensive care unit. Congenital anomalies were not found in either infant.: The patient was a 30-year-old woman with a 1-year history of infertility. Hysterosalpingogram revealed bilateral tubal occlusion. In a frozen/thawed cycle one blastocyst was transferred during her natural ovulation cycle. She achieved a pregnancy and delivered a 2,877-g female infant and a 2,544-g male infant at 36 weeks of gestation by cesarean section. The female infant was diagnosed with a neural tube defect. No congenital anomalies were detected in the male infant. We hypothesize that the DZTs might have been the result of concurrent embryo transfer and natural ovulation and intercourse.