Conjoined twins in a triplet pregnancy after intracytoplasmic sperm injection and blastocyst transfer: case report and review of the literature.
OBJECTIVE
To describe an exceptional case of conjoined twins in a triplet pregnancy after intracytoplasmic sperm injection (ICSI) and blastocyst transfer.


METHODS
Case report.


METHODS
University teaching hospital reproductive endocrinology department and infertility practice.


METHODS
A 34-year-old woman underwent ICSI and received two blastocysts transferred.


METHODS
Transvaginal ultrasonography performed sequentially during early pregnancy.


METHODS
Ultrasound images of the fetus in gestational sac.


RESULTS
Two gestational sacs in the uterus were revealed at the 5th week. At the 8th week of gestation, a single fetus was seen in one sac, whereas thoracopagus conjoined twins was diagnosed in the other sac. At the 10th week, the conjoined twins had a spontaneous cardiac arrest confirmed by color Doppler. The subsequent course was uneventful, and a healthy child was born at 39th week.


CONCLUSIONS
To date, a small number of cases of conjoined twins in IVF/ICSI pregnancies have been reported, in which most cases were treated with manipulations causing possible trauma in the zona pellucida. Our case is unique in that the transferred embryos were blastocysts that might have had additional damage on the zona pellucida from the longer culture.
Hirata
Tetsuya
T
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
Osuga
Yutaka
Y
Fujimoto
Akihisa
A
Oishi
Hajime
H
Hiroi
Hisahiko
H
Fujiwara
Toshihiro
T
Yano
Tetsu
T
Taketani
Yuji
Y
D000328:Adult; D001755:Blastocyst / Q000473:pathology*; D018618:Echocardiography, Doppler, Color; D046149:Embryo Culture Techniques; D004624:Embryo Transfer / Q000009:adverse effects*; D005260:Female; D005313:Fetal Death / Q000000981:diagnostic imaging / Q000209:etiology*; D005865:Gestational Age; D006323:Heart Arrest / Q000150:complications / Q000000981:diagnostic imaging / Q000196:embryology*; D006801:Humans; D050498:Live Birth; D011247:Pregnancy; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects*; D014310:Triplets; D014428:Twins, Conjoined / Q000196:embryology* / Q000473:pathology; D016216:Ultrasonography, Prenatal; D015044:Zona Pellucida / Q000473:pathology