Saravelos Sotirios H, Zhang Ting, Chung Jacqueline Pui Wah, Sun Lu-Ming, Sun Yun, Li Tin-Chiu, Chen Zi-Jiang
Assisted Reproductive Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Center for Reproductive Medicine, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200135, China.
J Assist Reprod Genet. 2016 Jan;33(1):27-32. doi: 10.1007/s10815-015-0611-2. Epub 2015 Nov 12.
The purpose of this study is to report two cases of monozygotic quadruplet and triplet pregnancies following single embryo transfer (ET).
A 29-year-old woman and a 34-year-old woman underwent ART treatment in two affiliated University based ART units. The first woman underwent ICSI with day 3 embryo biopsy for pre-implantation genetic diagnosis (PGD) followed by day 4 transfer, which resulted in a monochorionic quadramniotic (MCQA) quadruplet pregnancy. The second woman underwent conventional IVF with transfer of a single blastocyst, which resulted in a monochorionic triamniotic (MCTA) triplet pregnancy.
The first patient underwent successful selective foetal reduction at 16 + 3 and 17 + 4 weeks of gestation. Two healthy twin girls were delivered by elective caesarean section at 35 + 6 weeks of gestation. The second patient underwent successful selective foetal reduction at 14 + 1 weeks of gestation. The remaining monochorionic diamniotic (MCDA) twins are well at the time of writing this article.
To our knowledge, these cases represent the first case of viable MCQA pregnancy following single ET in the world and the third case of a viable MCTA pregnancy following conventional IVF with single ET. Several factors including blastocyst stage transfer and zona pellucida manipulation have been thought to contribute to monozygotic twinning in the context of ART. These two cases add to the growing literature of monozygotic multiple pregnancies following ART.
本研究旨在报告两例单胚胎移植（ET）后发生的单卵四胞胎和三胞胎妊娠病例。
一名29岁女性和一名34岁女性在两所大学附属医院的辅助生殖技术（ART）单位接受了ART治疗。第一名女性接受了卵胞浆内单精子注射（ICSI），并在第3天进行胚胎活检以进行植入前遗传学诊断（PGD），随后在第4天进行移植，结果为单绒毛膜四羊膜囊（MCQA）四胞胎妊娠。第二名女性接受了常规体外受精（IVF），移植了单个囊胚，结果为单绒毛膜三羊膜囊（MCTA）三胞胎妊娠。
第一名患者在妊娠16 + 3周和17 + 4周时成功进行了选择性减胎。在妊娠35 + 6周时通过择期剖宫产分娩了两名健康的双胞胎女孩。第二名患者在妊娠14 + 1周时成功进行了选择性减胎。在撰写本文时，其余的单绒毛膜双羊膜囊（MCDA）双胞胎情况良好。
据我们所知，这些病例代表了世界上首例单胚胎移植后存活的MCQA妊娠病例，以及常规IVF单胚胎移植后存活的MCTA妊娠的第三例病例。在ART背景下，包括囊胚期移植和透明带操作在内的几个因素被认为与单卵双胎有关。这两例病例增加了ART后单卵多胎妊娠的文献报道。
