Hirata Tetsuya, Osuga Yutaka, Fujimoto Akihisa, Oishi Hajime, Hiroi Hisahiko, Fujiwara Toshihiro, Yano Tetsu, Taketani Yuji
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
Fertil Steril. 2009 Mar;91(3):933.e9-12. doi: 10.1016/j.fertnstert.2008.07.1730. Epub 2008 Nov 1.
To describe an exceptional case of conjoined twins in a triplet pregnancy after intracytoplasmic sperm injection (ICSI) and blastocyst transfer.
Case report.
University teaching hospital reproductive endocrinology department and infertility practice.
PATIENT(S): A 34-year-old woman underwent ICSI and received two blastocysts transferred.
INTERVENTION(S): Transvaginal ultrasonography performed sequentially during early pregnancy.
MAIN OUTCOME MEASURE(S): Ultrasound images of the fetus in gestational sac.
RESULT(S): 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.
CONCLUSION(S): 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.
描述一例在卵胞浆内单精子注射（ICSI）及囊胚移植后的三胎妊娠中出现联体双胎的罕见病例。
病例报告。
大学教学医院生殖内分泌科及不孕不育诊疗机构。
一名34岁女性接受了ICSI并移植了两枚囊胚。
孕早期定期行经阴道超声检查。
妊娠囊内胎儿的超声图像。
孕5周时子宫内发现两个妊娠囊。孕8周时，一个囊内见单胎，而另一个囊内诊断为胸腹联体双胎。孕10周时，联体双胎经彩色多普勒证实发生了心脏骤停。随后过程顺利，孕39周时一名健康婴儿出生。
迄今为止，已有少数关于体外受精/ICSI妊娠中联体双胎的病例报道，其中大多数病例接受了可能导致透明带创伤的操作。我们的病例独特之处在于移植的胚胎为囊胚，可能因较长时间的培养而使透明带受到了额外损伤。
