The organization of the oocyte and embryogenesis in twinning and fusion malformations

Certain congenital malformations occur in excess among twins and also among first-degree relatives of twins. In the general population, these anomalies are familially associated with each other, and, like twinning, familially associated with unusual brain function asymmetry. They affect structures built by fusion of bilateral embryonic halves and remodeled under major influence of neural crest mesenchyme. This conjunction of associations suggests that twinning, symmetry development, and this group of malformations might share causal elements at least some of which are heritable. The problem here is the absence of zygosity differences in these relationships, because of which they cannot be explained within the biology of twinning as it has been understood. A potential resolution is offered by way of a mechanism common to MZ and DZ twinning, involving a relationship between oocyte organization and the determination of body symmetries.