Objective: An increased occurrence of monozygotic twinning has been documented when transferring in vitro-produced blastocysts (Behr et al., 1999). The spectrum of placentations observed in these pregnancies suggests that more than one mechanism may be responsible for monozygotic twinning (Meintjes et al., 2000). In vitro zona pellucida hardening and atypical hatching are typically proposed as possible causes of monozygotic twinning (Van Lagendonckt et al., 2000). The objective of this case study is to consider one other likely mechanism by which monozygotic twinning may result when transferring blastocysts. Design: A monozygotic triplet pregnancy was prospectively predicted based on the observation of two inner cell masses (ICM) in a transferred blastocyst. The patient history was then analyzed retrospectively. Materials/Methods: A 40-year old woman, G 2 , P 0 , A 2 was diagnosed with a deletion of the short arm of one of the X-chromosomes (46 X, del (X) (p22.1). Subsequently, a decision was made to proceed with donor oocyte IVF and blastocyst transfer. The oocyte donor was stimulated with recombinant FSH for 8 days, coasted for three days and hCG administered on day 11 of stimulation. 22 mature oocytes were retrieved and then sperm injected due to low sperm
Fertility and Sterility – Elsevier
Published: Sep 1, 2001
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