Iranian Journal of Reproductive Medicine (Nov 2015)

Conjoined twins in a monochorionic triplet pregnancy after in vitro fertilization: a case report

  • Marzieh Talebian,
  • Fatemeh Rahimi-Sharbaf,
  • Mahboobeh Shirazi,
  • Batool Teimoori,
  • Narges Izadi-mood,
  • Soheila Sarmadi

Journal volume & issue
Vol. 13, no. 11
pp. 729 – 732

Abstract

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Background: Monozygotic monochorionic triplet pregnancy with conjoined twins is a very rare condition and is associated with many complications. Case: In this study, we describe a monochorionic–diamniotic triplet pregnancy after in vitro fertilization with an intracytoplasmic sperm injection. At a gestational age of 6 weeks and 4 days of pregnancy one gestational sac was observed, and at a gestational age of 12 weeks and 2 days, triplets with conjoined twins were diagnosed. After consulting with the parents, they chose fetal reduction of the conjoined twins. Selective feticide was successfully performed by radiofrequency ablation at 16 weeks of pregnancy. Unfortunately, the day after the procedure, the membrane ruptured, and 1 week later, all fetuses and placenta were spontaneously aborted. Conclusion: Monochorionic triplet pregnancy with conjoined twins is very rare. These pregnancies are associated with very serious complications. Intra cytoplasmic sperm injection increases the rate of monozygotic twinning and conjoined twins. Counseling with parents before IVF is very important.