Konno Hiroko, Murakoshi Takeshi, Miura Kiyonori, Masuzaki Hideaki
Division of Obstetrics and Perinatology, Maternal and Perinatal Care Center, Seirei Hamamatsu General Hospital, Shizuoka, Japan.
Obstetrics and Gynecology, Nagasaki University School of Medicine, Nagasaki, Japan.
Twin Res Hum Genet. 2020 Feb;23(1):51-54. doi: 10.1017/thg.2020.5. Epub 2020 Mar 25.
Dichorionic diamniotic (DCDA) twin pregnancies after single blastocyst embryo transfer have been reported recently, although a blastocyst ovum is generally believed to divide into monochorionic twin pregnancy. We investigated the incidence of DCDA twin pregnancy after single blastocyst embryo transfer and their zygosity. This prospective cohort study included 655 consecutive twin pregnancies that were managed from 2006 to 2014 at our institution. Chorionicity and amnionicity were determined using first-trimester ultrasonography and/or placental pathology. Zygosity was analyzed if the cases were DCDA twins after single blastocyst embryo transfer. Among 655 twin pregnancies, there were 348 DCDA cases, 295 monochorionic diamniotic (MCDA) cases and 12 monochorionic monoamniotic cases. Single blastocyst embryo transfer was performed in 43 cases. Six out of the 43 (14%) cases involved DCDA twin pregnancies and the other 37 cases involved MCDA twin pregnancies. Three DCDA twins born after single blastocyst embryo transfer, wherein frozen embryo transfer (FET) was performed in the natural cycle, were dizygotic, and the other three cases, wherein FET with hormone replacement therapy was performed, were monozygotic. DCDA twin pregnancy occurred in 14% (7% for monozygotic and 7% for dizygotic) of twin pregnancies after single blastocyst embryo transfer cases.
近期有报道称，单囊胚胚胎移植后出现了双绒毛膜双羊膜囊（DCDA）双胎妊娠，尽管一般认为囊胚卵会分裂为单绒毛膜双胎妊娠。我们调查了单囊胚胚胎移植后DCDA双胎妊娠的发生率及其合子性。这项前瞻性队列研究纳入了2006年至2014年在我们机构管理的655例连续双胎妊娠。通过孕早期超声检查和/或胎盘病理学确定绒毛膜性和羊膜性。如果病例为单囊胚胚胎移植后的DCDA双胎，则分析其合子性。在655例双胎妊娠中，有348例DCDA病例、295例单绒毛膜双羊膜囊（MCDA）病例和12例单绒毛膜单羊膜囊病例。43例进行了单囊胚胚胎移植。43例中有6例（14%）为DCDA双胎妊娠，其他37例为MCDA双胎妊娠。单囊胚胚胎移植后出生的3例DCDA双胎中，其中在自然周期进行冻融胚胎移植（FET）的为双卵双胎，另外3例在进行激素替代疗法的FET时出生的为单卵双胎。单囊胚胚胎移植病例中，14%（单卵双胎7%，双卵双胎7%）的双胎妊娠为DCDA双胎妊娠。
