title: Complete hydatidiform mole with coexisting dichorionic diamniotic twins following testicular sperm extraction and intracytoplasmic sperm injection.
abstract: We present the first report of complete hydatidiform mole (HM) with coexisting dichorionic diamniotic twins. This pregnancy was achieved after testicular sperm extraction and intracytoplasmic sperm injection (ICSI) for azoospermia in the woman's husband. Standard in vitro fertilization may cause multisperm fertilization and increase triploid partial HM and complete HM, which arise from dispermic fertilization. In contrast, ICSI can avoid multisperm fertilization. In our case, paternal isodisomy in the molar tissue was confirmed by microsatellite analysis suggesting that it resulted from duplication of a haploid paternal genome following monospermic fertilization of an inactivated oocyte or from monospermic fertilization of an inactivated oocyte with a diploid sperm. Although the patient was eager to continue the pregnancy, the size of the HM component increased rapidly and termination of the pregnancy was required for pre-eclampsia-like symptoms at 15 weeks of gestation. After the operation, chemotherapy was initiated for persistent trophoblastic disease.
authors.affiliation: Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo, Japan. taka0197@med.hokudai.ac.jp
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamada
authors.forename: Takao
authors.initials: T
authors.lastname: Matsuda
authors.forename: Masataka
authors.initials: M
authors.lastname: Kudo
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamada
authors.forename: Masashi
authors.initials: M
authors.lastname: Moriwaki
authors.forename: Shinya
authors.initials: S
authors.lastname: Nishi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Ebina
authors.forename: Hideto
authors.initials: H
authors.lastname: Yamada
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kato
authors.forename: Tomoo
authors.initials: T
authors.lastname: Ito
authors.forename: Norio
authors.initials: N
authors.lastname: Wake
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sakuragi
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
mesh_terms: D000028:Abortion, Induced; D000328:Adult; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006828:Hydatidiform Mole / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D011247:Pregnancy; D020554:Sperm Injections, Intracytoplasmic; D014427:Twins; D016216:Ultrasonography, Prenatal; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery