Monochorionic Triplet Gestation after Single Blastocyst Transfer Using Donor Oocytes: Case Report and Review

Area of Science:

• Reproductive Medicine
• Maternal-Fetal Medicine
• Genetics

Background:

• Assisted reproductive technologies (ART) like in vitro fertilization (IVF) are increasingly utilized for infertility treatment.
• The incidence of multiple pregnancies, particularly monozygotic twins, appears higher in IVF compared to natural conception.
• Donor oocyte programs are a subset of IVF offering solutions for specific infertility challenges.

Observation:

• A 43-year-old patient conceived via IVF with donor oocytes.
• Ultrasound at 6 weeks and 5 days gestation revealed a monochorionic triamniotic (MCTA) triplet pregnancy.
• The pregnancy resulted from the transfer of a single blastocyst embryo.

Findings:

• The case presents a rare instance of MCTA triplets following a single embryo transfer in an IVF cycle using donor oocytes.
• This outcome highlights the potential for monozygotic twinning even with single embryo transfer in specific ART contexts.
• The underlying mechanisms contributing to increased monozygotic twinning rates in IVF remain unclear.

Implications:

• This case underscores the importance of careful patient selection and monitoring in ART to mitigate risks associated with multiple gestations.
• Further investigation into the causes of increased monozygotic twinning in IVF is crucial for developing preventative strategies.
• Preventing high-risk multiple pregnancies is essential for reducing obstetric and perinatal morbidity and mortality.