RESUMO
OBJECTIVE: To describe a case of conjoined twins after intracytoplasmic sperm injection (ICSI) and transfer of a single day 2 embryo. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 30-year-old woman underwent ICSI with a transfer of a single day 2 embryo. INTERVENTION(S): Vaginal ultrasound examination was performed during early pregnancy. RESULT(S): The diagnosis of conjoined twins was made by vaginal ultrasonography at 9 weeks' gestation. The conjoined fetuses were diagnosed as thoracopagus twins with a single beating heart shared between the thoraxes. Extensive ultrasound examination suggested an extremely poor prognosis, Therapeutic termination was performed at 11 weeks. CONCLUSION(S): Given that single embryo transfers are able to shed light on the real incidence of conjoined twins developed on day 2/3 or on day 5/6, this is of interest mechanistically. Thus, it should be taken into account when trying to determine the true incidence of conjoined twins and ultimately trying to understand why these anomalies occur. The importance of early expert vaginal ultrasonography in pregnancies resulting from assisted reproductive technologies is emphasized.
Assuntos
Transferência Embrionária/efeitos adversos , Injeções de Esperma Intracitoplásmicas/efeitos adversos , Gêmeos Unidos/patologia , Aborto Terapêutico , Adulto , Aconselhamento , Diagnóstico Precoce , Feminino , Idade Gestacional , Humanos , Gravidez , Resultado do Tratamento , Ultrassonografia Doppler em Cores , Ultrassonografia Pré-NatalRESUMO
PURPOSE: While extended culture has been considerably improved, some questions remain regarding the application of Single Blastocyst Transfer (SBT). METHODS: An observational cohort study was undertaken with 456 women under 36 years old and assigned to SBT on a voluntary basis. The main outcome was the cumulative delivery rate per couple according to the number of Top Quality Embryos (TQE) on day 2 (Group 1= > or =2 TQE, Group 2= 1 TQE and Group 3= 0 TQE). RESULTS: Rate of transfer and mean number of frozen blastocyts were higher in Group 1 compared to Group 3. As a consequence, the cumulative delivery rate per couple was higher in Group 1 (47.9%) compared to Group 3 (34.9%). CONCLUSIONS: Single blastocyst transfer combining fresh and frozen cycles, might be a worthwhile strategy irrespective of embryo quality on day 2 providing good delivery rates while keeping the rate of multiple deliveries low.
