来自联体卵子的二卵双胎：病例报告。
Dizygotic twin from conjoined oocytes: a case report.
机构信息
Al-Yasmeen Fertility and Gynecology Center, 5 Farid Nada Street, Benha, Qalubyia, 13511, Egypt.
出版信息
J Assist Reprod Genet. 2020 Jun;37(6):1367-1370. doi: 10.1007/s10815-020-01772-z. Epub 2020 Apr 13.
PURPOSE
Binovular follicles including a pair of conjoined oocytes within a common zona pellucida or their fusion in the zonal region gained some attentions due to its possible role in dizygotic twins. Although some cases in the literature been reported in which two conjoined oocytes arising from binovular follicles were mature, and injected with two separated sperm, no available evidence reported for dizygotic twin pregnancies.
METHODS
A case report of a 37-year-old female patient underwent embryo transfer cycle whereby a pair of conjoined blastocysts after ICSI of a pair of conjoined oocytes was transferred.
RESULTS
The β-hCG level was positive 15 days after embryo transfer. The subsequent pregnancy scan revealed a dizygotic pregnancy. The woman gave birth to two healthy boys in the mid of 38 weeks of gestation by cesarean section.
CONCLUSIONS
Given the insufficient evidence on how to handle conjoined oocytes, this report acknowledges the first occurrence of dizygotic twin delivery resulted from transfer of a pair of conjoined blastocysts after ICSI of a pair of conjoined oocytes. This also confirms that we should be extremely conservative in discarding any mature oocyte without sufficient data about its useless future to result in a healthy baby.
目的
由于双卵泡内包含一对连体卵母细胞或它们在透明带区域融合可能在双胎妊娠中起作用，因此包含一对连体卵母细胞的双卵泡引起了一些关注。尽管文献中有一些报告称，来自双卵泡的两个连体卵母细胞成熟并分别注入两个精子，但尚无关于双胎妊娠的可用证据。
方法
报告了一例 37 岁女性患者的胚胎移植周期，其中一对连体卵母细胞经 ICSI 受精后形成一对连体囊胚进行移植。
结果
胚胎移植后 15 天β-hCG 水平阳性。随后的妊娠超声检查显示为双胎妊娠。该妇女在妊娠 38 周中期通过剖宫产分娩了两个健康男婴。
结论
鉴于关于如何处理连体卵母细胞的证据不足，本报告承认首例通过 ICSI 受精一对连体卵母细胞后移植一对连体囊胚导致双胎妊娠分娩的情况。这也证实，我们应该非常谨慎地处理任何没有足够数据表明其未来无用的成熟卵母细胞，以免导致健康婴儿的出生。
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