Gurunath Sumana, Makam Adinarayana, Vinekar Sriprada, Biliangady Reeta H
Department of Reproductive Medicine, Cloudnine Hospitals, Malleshwaram, Karnataka, India.
Department of Fetal Medicine, People Tree Hospitals, Bengaluru, Karnataka, India.
J Hum Reprod Sci. 2015 Jan-Mar;8(1):54-7. doi: 10.4103/0974-1208.153131.
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.
随着移植胚胎数量的减少,体外受精(IVF)中的多胎妊娠正在下降。但单卵分裂的风险仍然存在。据报道,接受IVF的女性中单卵双胎的风险是自然受孕的两倍,而单绒毛膜三胞胎甚至更罕见,比自然受孕多100倍。我们报告了一例在常规IVF和囊胚移植后未经透明带操作的单绒毛膜三羊膜囊(MCTA)三胞胎病例。本报告强调了在没有家族史的年轻夫妇中,在有良好囊胚移植经验的中心进行IVF时合子分裂的可能性。MCTA三胞胎围产期死亡率和发病率风险很高,需要多学科护理。应通过更好地报告和识别可能的风险因素来实现合子分裂的预防和预测。