在试管受精过程中首例自发受孕病例被报告
WESTPORT, CT (Reuters Health) - The first known case of spontaneous conception concurrent with in vitro fertilization (IVF) is reported by Stanford University researchers in the November issue of Human Reproduction.
Dr. Amin A. Milki and colleagues from California report the case of a 35-year-old nulliparous woman and her husband who had failed 12 cycles of intrauterine insemination. Seven weeks after IVF an ultrasound showed a quadruplet pregnancy with thick dividing membranes and a lambda sign between all four sacs.
After 32 weeks of gestation, the woman gave birth to three girls and a boy by elective caesarean section. The boy and one of the girls had separate placentas while the other two girls had fused placentas, the researchers report. DNA analysis suggested that the boy and one of the girls were fraternal twins and the other two girls were identical twins.
"It would appear that the two transferred embryos led to fraternal twins, and a spontaneous conception with the embryo splitting in vivo by day 4 resulted in identical twins," Dr. Milki said in a journal statement.
"The couple had admitted having intercourse 5 days prior to the retrieval of eggs for IVF," he explained. "It is just possible that the identical twins could have resulted from one of the transferred embryos splitting. But even if that were true at least one fetus would have been conceived spontaneously. That is incontestable based on the genetic testing."
Dr. Milki added that "it may be prudent to caution IVF patients with no tubal or semen abnormalities against unprotected intercourse once the early days of ovarian hyperstimulation are over, especially if they will not consider fetal reduction in the event of a multiple pregnancy."
Hum Reprod 2001;16:2324-2326.
-Westport Newsroom 203 319 2700, http://www.100md.com
Dr. Amin A. Milki and colleagues from California report the case of a 35-year-old nulliparous woman and her husband who had failed 12 cycles of intrauterine insemination. Seven weeks after IVF an ultrasound showed a quadruplet pregnancy with thick dividing membranes and a lambda sign between all four sacs.
After 32 weeks of gestation, the woman gave birth to three girls and a boy by elective caesarean section. The boy and one of the girls had separate placentas while the other two girls had fused placentas, the researchers report. DNA analysis suggested that the boy and one of the girls were fraternal twins and the other two girls were identical twins.
"It would appear that the two transferred embryos led to fraternal twins, and a spontaneous conception with the embryo splitting in vivo by day 4 resulted in identical twins," Dr. Milki said in a journal statement.
"The couple had admitted having intercourse 5 days prior to the retrieval of eggs for IVF," he explained. "It is just possible that the identical twins could have resulted from one of the transferred embryos splitting. But even if that were true at least one fetus would have been conceived spontaneously. That is incontestable based on the genetic testing."
Dr. Milki added that "it may be prudent to caution IVF patients with no tubal or semen abnormalities against unprotected intercourse once the early days of ovarian hyperstimulation are over, especially if they will not consider fetal reduction in the event of a multiple pregnancy."
Hum Reprod 2001;16:2324-2326.
-Westport Newsroom 203 319 2700, http://www.100md.com