title: Quintuplets after a transfer of two embryos following in vitro fertilization: a proved superfecundation.
abstract: OBJECTIVE
  To report a genetically proved superfecundation of quintuplets after transfer of two embryos in IVF procedure and successful completion of the pregnancy after fetal reduction.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Academic reproductive medicine center.
  
  
  METHODS
  A 31-year-old woman, gravida 0, who underwent her second IVF cycle after three IUIs.
  
  
  METHODS
  After 5 years of primary infertility, three IUIs, and one IVF, the patient underwent her second IVF cycle with transfer of two fresh embryos on day 2.
  
  
  METHODS
  Development of five separate embryonic sacs. Fetal reduction to twins at 12 weeks of gestation. Successful pregnancy and delivery. Deoxyribonucleic acid analysis of the three reduced embryos, the live-born twins, and their parents.
  
  
  RESULTS
  Analysis of the seven DNA samples, because all were different, confirmed the superfecundation and disproved the zygote's division after transfer. Fetal growth restriction motivated preterm delivery by cesarean section. Both twins were in good health.
  
  
  CONCLUSIONS
  Superfecundation can explain high-order multiple pregnancy and can be proved by DNA analysis. Couples must be informed because of the implications of fetal reduction for ethical issues, risks of pregnancy loss, fetal growth restriction, preterm delivery, and its consequences.
authors.affiliation: Service de Gynécologie endocrinienne et Médecine de la Reproduction, CHRU Lille, France. maeliss_peigne@hotmail.com
authors.forename: Maëliss
authors.initials: M
authors.lastname: Peigné
authors.forename: Joris
authors.initials: J
authors.lastname: Andrieux
authors.forename: Philippe
authors.initials: P
authors.lastname: Deruelle
authors.forename: Isabelle
authors.initials: I
authors.lastname: Vuillaume
authors.forename: Maryse
authors.initials: M
authors.lastname: Leroy
mesh_terms: D000328:Adult; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D005298:Fertility / Q000502:physiology*; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal; D011272:Pregnancy, Multiple / Q000502:physiology; D011811:Quintuplets; D014427:Twins