Successful pregnancy and delivery of two sets of monozygotic twins after intracytoplasmic sperm injection and embryo transfer: case report and literature review

Scientific paper - Case study

• Author: Ozren Grgić
• Author: Marina Ivanišević
• Author: Josip Đelmiš
• Author: Dražen Lučinger
• Author: Lana Krile
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

Objective: To report a unique case of successful pregnancy and delivery of two pairs of monozygotic twins (quadruplets) after intracytoplasmic sperm injection (ISCI) and transfer of two blastocysts. ----- Design: Case report. ----- Setting: University medical center. ----- Patient: A 30 year old nulligravida, who had first ISCI, assisted hatching and fresh embryo transfer because of a male factor of infertility (severe olygoasthenozoospermia). ----- Interventions: Prophylactic cervical cerclage sec. McDonald in 21st week of pregnancy, hospitalization and intensive care of pregnancy, ending with delivery by planned cesarean section (CS) in 34th week of pregnancy. ----- Main Outcome Measure: Successful pregnancy and delivery of two male and two female twins in 34th week of pregnancy. ----- Results: Two blastocysts were divided and 4 embryos developed. After extensive counseling the couple decided to keep all embryos. In 21st week prophylactic cerclage was preformed. During hospitalization the ultrasound examination was performed every 2 weeks, and from 30th week on a cardiotocogram was recorded. At 33rd week her blood pressure increased and she received antihypertensive therapy. At 34th week planned CS was performed and four newborns (two male monochorionic monoamniotic twins, and two female monochorionic biamniotic twins) weighted between 1300 – 2170 grams were born. ----- Conclusion: Even without embryoreduction the intensive care throughout pregnancy including prophylactic cerclage, bed rest, prophylactic anticoagulant and antihypertensive therapy results in delivery of four healthy newborns.

• Keywords (english): Adult; Cesarean Section; Delivery, Obstetric; Embryo Transfer/methods; Female; Humans; Infant, Newborn; Pregnancy; Sperm Injections, Intracytoplasmic/methods; Treatment Outcome; Twins, Monozygotic; Ultrasonography, Prenatal
• Language: english
• Publication type: Scientific paper - Case study
• Publication status: Published
• Peer review: Peer review
• Publication version: Accepted version
• Journal title: Fertility and Sterility
• Numbering: vol. 92, no. 1, pp. 392.e5-392.e8
• p-ISSN: 0015-0282
• DOI: https://doi.org/10.1016/j.fertnstert.2009.04.011
• URN:NBN: urn:nbn:hr:105:933097
• Publication: 2009-07
• Document URL: https://doi.org/10.1016/j.fertnstert.2009.04.011
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 11:16:44