title: High incidence of triploidy in in-vitro fertilized oocytes from a patient with a previous history of recurrent gestational trophoblastic disease.
abstract: The patient described has a history of recurrent gestational trophoblastic disease following spontaneous conception. She subsequently underwent two cycles of in-vitro fertilization (IVF) for management of infertility related to tubal obstruction. IVF of the oocytes retrieved showed a significantly high incidence of abnormal fertilization resulting in the development of triploid embryos. This report explores the possible association of an oocyte defect predisposing to abnormal fertilization, resulting in a high incidence of triploid embryos. Since the development of partial hydatidiform moles is related to the origin of triploidy, this phenomenon is suggested to explain the occurrence of recurrent trophoblastic disease in this patient. We propose the use of intracytoplasmic sperm injection (ICSI) as a therapeutic option to minimize the incidence of triploidy in future IVF cycles; donor oocyte IVF would be another alternative.
authors.affiliation: Department of Reproductive Endocrinology and Infertility, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
authors.forename: L
authors.initials: L
authors.lastname: Pal
authors.forename: T L
authors.initials: TL
authors.lastname: Toth
authors.forename: L
authors.initials: L
authors.lastname: Leykin
authors.forename: K B
authors.initials: KB
authors.lastname: Isaacson
mesh_terms: D000328:Adult; D003593:Cytoplasm; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D006828:Hydatidiform Mole / Q000235:genetics*; D008297:Male; D008845:Microinjections; D011123:Polyploidy; D011247:Pregnancy; D012008:Recurrence; D013094:Spermatozoa; D015053:Zygote / Q000648:ultrastructure*