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monozygotic twinning after donor egg intracytoplasmic sperm injection-A case report

Asian pacific Journal of Reproduction 2018年第5期7卷 239-240页

作者： Manjushri Kothekar Richa Jagtap Institute of NOVA IVI Fertility MumbaiIndia

We are reporting a case of monozygotic twinning after donor egg intracytoplasmic sperm injection (ICSI). A 34-year-old lady presented to our centre with primary infertility due to severe endometriosis and low egg reserve. ICSI with donor eggs was planned. A 24 years old voluntary oocyte donor was investigated and stimulated under antagonist protocol. Total 21 eggs and all in metaphaseⅡwere retrieved. These eggs were injected with the patient's husband sperms by ICSI. Patient's endometrial lining was prepared under hormonal replacement therapy protocol. Two expanded blastocysts were transferred on day 5 of progesterone. Beta human chorionic gonadotropin was positive after 10 days. The first antenatal scan at 6 weeks could pick up only two sacs indicating twin conception. Repeat scan at 12 weeks revealed tri-amniotic triplet conception with two foetuses sharing the same placenta (triamniotic pregnancy with monochorionic twins). The patient was counselled about risks associated with triplet conception and was advised of embryo reduction. Two mono chorionic twins were reduced under ultrasonography guidance. Single pregnancy continued till 21 weeks after which the patient miscarried spontaneously. It is difficult to identify the subset of patients at risk for monozygotic twinning;hence, all patients should be counselled about possibility of monozygotic twinning while deciding the number of embryos to be transferred.

关键词： monozygotic Twins Donor egg ICSI

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Prenatal Phenotypical Discrepancy in monozygotic Twins with Tuberous Sclerosis Complex

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Maternal-Fetal Medicine 2022年第4期4卷 286-289页

作者： Shiyi Xiong Fengyu Wu Guangquan Chen Jian Wang Yingjun Yang Ya Xing Luming Sun Fetal Medicine Unit&Prenatal Diagnosis Center Shanghai First Maternity and Infant HospitalTongji UniversityShanghai 201204China Department of Medical Genetics and Molecular Diagnostic Laboratory Shanghai Children's Medical CenterShanghai Jiaotong University School of MedicineShanghai 200127China.

Tuberous sclerosis complex (TSC) is an autosomal-dominant genetic disorder characterized by the development of hamartomas in the brain, heart, skin, kidney, lung, retina, and so on. One fetus from family 1 had a cardiac rhabdomyoma from 21 weeks and 6 days of gestational age, and developed multiple rhabdomyomas and tubers in the brain at 23 weeks and 5 days. The counter monozygotic twin fetus remained negative throughout the pregnancy according to imaging examination. A nonsense mutation inTSC2 (c.4762C>T, ***1588*) was identified in both twins, but not in the mother. Family 2 was one pair of twin fetuses caused by a microdeletion of exon 30 withinTSC2 inherited from their apparently asymptomatic mother with mosaic status. The larger fetus was identified as having the first cardiac rhabdomyoma from 17 weeks and 4 days of gestational age. The smaller fetus developed multiple rhabdomyomas until 25 weeks and 6 days of gestational age. Both families terminated the pregnancy. Here, we provide intrauterine examples of clinical variability among monozygotic twins suffering from TSC.

关键词： Twins monozygotic Rhabdomyoma Tuberous sclerosis complex

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Clinical scenarios of quadruplet pregnancy by transfer of two blastocysts—A case report

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Open Journal of Obstetrics and Gynecology 2012年第1期2卷 73-75页

作者： Hossain Amjad Havemann Dara Castle Debra Phelps John Department of Obstetrics and Gynecology University of Texas Medical Branch Galveston USA

Blastocyst transfer is advocated to reduce the risk of multiple gestations in pregnancies by assisted reproduction. Nevertheless, there remains the rare inherit possibility of embryo splitting that can result in monozygotic twins leading to high-order multiples. Also, when a patient is found to have a higher gestation than the number of embryos transferred it calls into question the IVF facility’s competency and credibility. The case report presented such a rare phenomenon of embryo splitting and the clinical consequences precipitated from it. In the patient, two blastocysts were transferred 5 days after transvaginal oocyte retrieval. The pregnancy confirming hCG test did not predict high-order multiples in this case. Early ultrasonography documented trichorionic-quadramnionic gestation. Selective reduction of the monochorionic twins was done at 11 weeks. Dichorionic twin gestation continued uneventful until 22 weeks at which point the patient experienced preterm premature rupture of membranes with subsequent delivery. The pathology report confirmed trichorionic-quadramnionic gestation. The mode of splitting was different for the two embryos one leading to monozygotic dichorionic and the other to monozygotic monochorionic. Furthermore, the implantation was also apparently asynchronous with one implanted considerable later than the other. The first β-hCG value seemingly did not represent the entire initial implementation events otherwise the value would be higher carrying the early signal of high-order multiple.

关键词： Blastocyst monozygotic Twinning Quadruplets IVF

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Heritability of Heart Rate Response to Arousals in Twins

Heritability of Heart Rate Response to Arousals in Twins

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中国睡眠研究会第十届全国学术年会

作者： Xiaoling Gao Ali Azarbarzin Brendan T.Keenan Michele Ostrowski Frances M.Pack Bethany Staley Greg Maislin Allan I.Pack Magdy Younes Samuel T.Kuna Department of Medicine and Center for Sleep and Circadian Neurobiology University of Pennsylvania Department of Respiration The Second Hospital of Shanxi Medical University Division of Sleep Medicine Brigham and Women’s Hospital and Harvard Medical School Sleep Disorders Centre University of Manitoba

Objectives: To determine if the large and highly reproducible interindividual differences in arousal intensity and heart rate response to arousal（ΔHR） during non-REM sleep are ***: Polysomnograms of 55 monozygotic（14 male and 41 female pairs） and 36 dizygotic（15 male and 21 female pairs） same-sex twin pairs were *** were scored using the 2012 American Academy of Sleep Medicine *** intensity was scaled（between 0 and 9） using an automatic algorithm based on the change in electroencephalogram time and frequency *** ΔHR was determined at each *** calculated average arousal duration,average arousal intensity,average overall ΔHR,average ΔHR at a given arousal intensity,slope of ΔHR per arousal intensity,and arousal intensity threshold of Δ***: The intraclass correlations among monozygotic and dizygotic twin pairs were 0.663 and 0.146,respectively,for average arousal intensity,and 0.449 and 0,respectively,for arousal intensity threshold of ΔHR controlling for age,sex,and *** values imply large broad sense heritability（H2） for these *** evidence was confirmed by a robust maximum likelihood-based variance components estimation approach,with an additive genetic heritability of 0.64（95% confidence interval: 0.48 to 0.80） for average arousal intensity and a combined additive and dominance genetic heritability and of 0.46（0.25 to 0.68） for arousal intensity threshold of Δ*** also suggested significant additive genetic effects for average arousal duration,ΔHR at arousal intensity scale 4 and the overall average Δ***: Genetic factors explain a significant fraction of the phenotypic variability for average arousal intensity and arousal intensity threshold of Δ*** suggest that the duration of arousals and specific average ΔHR values may also be heritable traits.

关键词： polysomnogram monozygotic dizygotic

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