title: Monochorionic triamniotic triplets following conventional in vitro fertilization and blastocyst transfer.
abstract: Multiple pregnancy in in vitro fertilization (IVF) is on the decline with a reduction in number of embryos transferred. But the risk of monozygotic splitting persists. The risk of monozygotic twinning in women undergoing IVF is reported to be twice that of natural conception, and monochorionic triplets are even rarer at 100 times more than natural conception. We report a case of monochorionic triamniotic (MCTA) triplets following conventional IVF and blastocyst transfer without zona manipulation. This report highlights the possibility of zygotic splitting in IVF in young couples with no family history, in centers with good experience with blastocyst transfer. MCTA triplets carry a high risk of perinatal mortality and morbidity and need multidisciplinary care. Prevention and prediction of zygotic splitting ought to be realized with better reporting and identification of possible risk factors.
authors.affiliation: Department of Reproductive Medicine, Cloudnine Hospitals, Malleshwaram, Karnataka, India.
authors.forename: Sumana
authors.initials: S
authors.lastname: Gurunath
authors.affiliation: Department of Fetal Medicine, People Tree Hospitals, Bengaluru, Karnataka, India.
authors.forename: Adinarayana
authors.initials: A
authors.lastname: Makam
authors.affiliation: Department of Gynaecology, Cloudnine Hospitals, Malleshwaram, Karnataka, India.
authors.forename: Sriprada
authors.initials: S
authors.lastname: Vinekar
authors.affiliation: Department of Reproductive Medicine, Cloudnine Hospitals, Malleshwaram, Karnataka, India.
authors.forename: Reeta H
authors.initials: RH
authors.lastname: Biliangady
keywords: Blastocyst transfer; in vitro fertilization; monochorionic triamniotic triplet; zygotic splitting
references.citation: Hum Reprod. 1994 Feb;9(2):374-5
references.pmid: 8027300
references.citation: Case Rep Obstet Gynecol. 2012;2012:763057
references.pmid: 23320217
references.citation: Hum Reprod Update. 2009 Jan-Feb;15(1):45-55
references.pmid: 18927071
references.citation: Fertil Steril. 2005 Mar;83(3):742-8
references.pmid: 15749508
references.citation: Fertil Steril. 2008 May;89(5):1260.e9-12
references.pmid: 17628555
references.citation: J Assist Reprod Genet. 2004 Apr;21(4):103-7
references.pmid: 15270208
references.citation: Hum Reprod. 1995 Nov;10(11):3064-6
references.pmid: 8747075
references.citation: J Exp Clin Assist Reprod. 2007 Sep 22;4:4
references.pmid: 17888172
references.citation: Reprod Biomed Online. 2010 Sep;21(3):283-9
references.pmid: 20638341
references.citation: Twin Res. 2003 Feb;6(1):1-6
references.pmid: 12626221