title: Dichorionic twins and monochorionic triplets after the transfer of two blastocysts.
abstract: OBJECTIVE
  To describe a unique case of MZ dichorionic twins and MZ monochorionic triplets in a quintuplet gestation after intracytoplasmatic sperm injection (ICSI) and blastocyst transfer.
  
  
  METHODS
  Case report. A 24-year-old woman underwent ICSI and received two blastocysts transferred. A quintuplet gestation was established .Transvaginal ultrasonography was performed sequentially during early pregnancy.
  
  
  RESULTS
  Three intrauterine gestational sacs were revealed at about 5th week. At the 7th week, five gestational sacs presenting heart beats were detected and a quintuplet pregnancy consisting of two monozygotic (MZ) dichorionic twins and three MZ monochorionic triplets was determined. At the 10th week, a single gestational sac with heart beats was detected. The prenatal course was uneventful. A healthy baby was born at 36th week.
  
  
  CONCLUSIONS
  Few other reports have described the occurrence of a quintuplet gestation after the transfer of two blastocysts generated by ICSI. Our case is unique in that the two blastocysts underwent two different splitting processes, which occurred possibly at a similar time giving rise to MZ dichorionic twins and MZ monochorionic triplets.
authors.affiliation: Nilo Frantz Research and Human Reproduction Center, Porto Alegre, RS, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Ferreira
authors.forename: Adriana
authors.initials: A
authors.lastname: Bos-Mikich
authors.forename: Marcos
authors.initials: M
authors.lastname: Höher
authors.forename: Nilo
authors.initials: N
authors.lastname: Frantz
mesh_terms: D000328:Adult; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D058746:Gestational Sac / Q000000981:diagnostic imaging*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D020554:Sperm Injections, Intracytoplasmic; D014310:Triplets; D014427:Twins; D016216:Ultrasonography, Prenatal