Complete hydatidiform mole with coexisting dichorionic diamniotic twins following testicular sperm extraction and intracytoplasmic sperm injection.
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.
Yamada
Takahiro
T
Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku, Sapporo, Japan. taka0197@med.hokudai.ac.jp
Matsuda
Takao
T
Kudo
Masataka
M
Yamada
Takashi
T
Moriwaki
Masashi
M
Nishi
Shinya
S
Ebina
Yasuhiko
Y
Yamada
Hideto
H
Kato
Hidenori
H
Ito
Tomoo
T
Wake
Norio
N
Sakuragi
Noriaki
N
Minakami
Hisanori
H
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