Dichorionic triplets following frozen-thawed poor-stage embryo transfer: a report of two cases and a review

Abstract

BackgroundWe describe two cases of dichorionic triplet pregnancy after a frozen-thawed poor-stage embryo transfer.Main body of the abstractA 39-year-old and a 41-year-old woman underwent ART treatment. The first patient underwent intracytoplasmic sperm injection (ICSI) at 34 years of age, and two frozen-thawed poor-stage embryos were transferred at 39 years of age with assisted hatching, resulting in a trichorionic triamniotic triplet pregnancy. The second patient underwent ICSI, and two poor-grade blastocysts were transferred followed by assisted hatching, resulting in a dichorionic triamniotic triplet pregnancy.In the first case, the heartbeat of one monozygotic twin fetus had stopped on day 48 post-transfer (9 weeks 2 days), resulting in a dichorionic diamniotic twin pregnancy. A healthy boy and girl were delivered by elective caesarean section at 36 weeks, 5-days gestation. In the second case, the patient underwent selective reduction of the monochorionic twins, resulting in a single pregnancy that was vaginally delivered without any problems at 38 weeks 0-days gestation.Short conclusionsNumerous factors may be associated with the development of a monochorionic pregnancy; however, controversies still remain. The present morphological grading for embryos is insufficient for inhibiting the development of a monochorionic pregnancy.

Repeated triplets complicated by monochorionic diamniotic twins following assisted reproduction: a case report and literature review

“…It is well-known that monochorionic twins are at high risk of maternal and fetal complications, including low birthweight, preterm birth, twin-twin transfusion syndrome(TTTS), umbilical cord accidents and perinatal mortality [6][7][8][9]. Regarding dichorionic triplets pregnancy, the rate was only 0.004% among all the pregnancies, as previously reported [10]. Here, we describe a rare case of repeated triplet pregnancy complicated by a monochorionic diamniotic twin in a patient after assisted reproduction.…”

Two is a Crowd

“…However, this ubiquitous model could indeed be plausible in DC‐DA and MC‐DA twins. This argument can be strengthened by the fact that after, for example, assisted fertility treatment—which often yields multiple gestations—both monozygotic DC‐DA and MC‐DA twins occur (Wehbe et al, ; Yanaihara et al, ). However—and to the best of our knowledge—we did not come across any reports of MC‐MA twins after infertility therapy, indicating that the model of postzygotic fission is perhaps not applicable for MC‐MA twins.…”