Triplet pregnancies after single blastocyst embryo transfer-how often and why do these occur?

IF 2.7 3区医学 Q2 GENETICS & HEREDITY

Journal of Assisted Reproduction and Genetics Pub Date : 2025-08-01 Epub Date: 2025-07-28 DOI:10.1007/s10815-025-03593-4

Ariel Woods, Steven R Lindheim, Saira Kothari, Dean E Morbeck, Emily N Liu, Amy Zhu, Nigel Pereira

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引用次数: 0

Abstract

Single embryo transfer (sET) has been adopted by assisted reproductive technology (ART) clinics globally to increase the rate of singleton births and reduce multi-fetal pregnancies. Independent ART registry-based studies have reported an association between monozygotic (MZ) splitting and sET, especially after single blastocyst embryo transfer (sBET). While MZ twins after sBET are not uncommon, MZ triplet pregnancies after sBET are exceptionally rare. In this context, we report two cases of MZ triplet pregnancies after sBET. The first case is of a 29-year-old woman with a unicornuate uterus who conceived a tri-chorionic triplet pregnancy after single euploid blastocyst transfer in a medicated frozen embryo transfer (FET) cycle. The second case is of a 34-year-old woman with a triplet pregnancy consisting of monochorionic diamniotic twins and a singleton after the transfer of an untested blastocyst in a natural FET cycle. Using these cases, we focus on the epidemiology and putative mechanisms of MZ splitting. Given that sBET does not eliminate the risk of multiple pregnancy entirely, it is important to counsel couples about the risks of MZ twins and triplets with sBET.

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单囊胚移植后三胞胎妊娠——发生的频率和原因？

单胚胎移植（sET）已被全球辅助生殖技术（ART）诊所采用，以提高单胎出生率和减少多胎妊娠。基于ART注册的独立研究报道了同卵（MZ）分裂与sET之间的关联，特别是在单囊胚胚胎移植（sBET）后。虽然sBET后的MZ双胞胎并不罕见，但sBET后的MZ三胞胎妊娠非常罕见。在这种情况下，我们报告两例MZ三胞胎妊娠后sBET。第一个病例是一名29岁的独角子宫女性，在单整倍体囊胚移植后，在药物冷冻胚胎移植（FET）周期中孕育了三绒毛膜三胞胎妊娠。第二个病例是一名34岁的妇女，在自然FET周期中移植未经测试的囊胚后，她怀孕了三胞胎，包括单绒毛膜双羊膜双胞胎和单胎。利用这些病例，我们重点讨论了MZ分裂的流行病学和可能的机制。鉴于sBET并不能完全消除多胎妊娠的风险，向夫妇咨询MZ双胞胎和三胞胎sBET的风险是很重要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Assisted Reproduction and Genetics 医学-妇产科学

CiteScore

5.70

自引率

9.70%

发文量

286

审稿时长

1 months

期刊介绍： The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species. The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.