Quintuplets after a transfer of two embryos following in vitro fertilization: a proved superfecundation

Objective To report a genetically proved superfecundation of quintuplets after transfer of two embryos in IVF procedure and successful completion of the pregnancy after fetal reduction. Design Case report. Setting Academic reproductive medicine center. Patient(s) A 31-year-old woman, gravida 0, who...

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Bibliographic Details
Published in:Fertility and sterility 2011-05, Vol.95 (6), p.2124.e13-2124.e16
Main Authors: Peigné, Maëliss, M.D, Andrieux, Joris, M.D., Ph.D, Deruelle, Philippe, M.D., Ph.D, Vuillaume, Isabelle, M.D, Leroy, Maryse, M.D
Format: Article
Language:English
Subjects:
Adult
case studies
cesarean section
DNA
Embryo Transfer - methods
ethics
Female
Fertility - physiology
Fertilization in Vitro - methods
fetal development
fetal reduction
genetic analysis
Humans
in vitro fertilization
Infant, Newborn
Internal Medicine
IVF
medicine
Obstetrics and Gynecology
parents
patients
Pregnancy
Pregnancy Reduction, Multifetal
Pregnancy, Multiple - physiology
Quintuplets
risk
Superfecundation
Twins
women
zygote
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Summary:Objective To report a genetically proved superfecundation of quintuplets after transfer of two embryos in IVF procedure and successful completion of the pregnancy after fetal reduction. Design Case report. Setting Academic reproductive medicine center. Patient(s) A 31-year-old woman, gravida 0, who underwent her second IVF cycle after three IUIs. Intervention(s) After 5 years of primary infertility, three IUIs, and one IVF, the patient underwent her second IVF cycle with transfer of two fresh embryos on day 2. Main Outcome Measure(s) Development of five separate embryonic sacs. Fetal reduction to twins at 12 weeks of gestation. Successful pregnancy and delivery. Deoxyribonucleic acid analysis of the three reduced embryos, the live-born twins, and their parents. Result(s) Analysis of the seven DNA samples, because all were different, confirmed the superfecundation and disproved the zygote’s division after transfer. Fetal growth restriction motivated preterm delivery by cesarean section. Both twins were in good health. Conclusion(s) Superfecundation can explain high-order multiple pregnancy and can be proved by DNA analysis. Couples must be informed because of the implications of fetal reduction for ethical issues, risks of pregnancy loss, fetal growth restriction, preterm delivery, and its consequences.
ISSN:0015-0282
1556-5653
DOI:10.1016/j.fertnstert.2011.01.029