Confined blood chimerism in a monochorionic dizygotic sex discordant twin pregnancy conceived after induced ovulation

Birth Defects Res A Clin Mol Teratol. 2016 Apr;106(4):298-303. doi: 10.1002/bdra.23457. Epub 2016 Mar 2.

Abstract

Background: Monochorionic twins are generally considered as a monozygotic twin pregnancy. However, several cases of monochorial dizygotic twin pregnancies have been reported.

Case report: We report on a rare case of monochorionic dizygotic twin pregnancy conceived after induced ovulation in a 32-year-old woman. The diagnosis was made on morphological ultrasound examination at 18+4 weeks of gestation, showing two fetuses with discordant sex. The amniocentesis was declined by the patient.

Results: The monochorionic status was confirmed after a histopathalogical study of the placenta. At delivery, both a phenotypically normal boy and a phenotypically normal girl without sexual abnormality were observed. This analysis also revealed the presence of vascular anastomoses between both fetal circulations. Postnatal cytogenetic analyses indicated the presence of a chimerism in peripheral blood lymphocytes. This chimerism was not observed in cells obtained from a buccal swab. Molecular determination of zygosity confirmed the existence of the confined peripheral blood chimerism with the presence of four parental alleles.

Conclusion: We report on a case of monochorionic dizygotic twin pregnancy. This observation underlies the need to carefully assess twin pregnancies, especially when obtained after assisted reproductive technology.

Keywords: ART; assisted reproductive technology; confined peripheral blood chimerism; monochorionic dizygotic twins.

Publication types

  • Case Reports
  • Twin Study

MeSH terms

  • Adult
  • Chimerism*
  • Female
  • Humans
  • Male
  • Ovulation Induction
  • Pregnancy
  • Twins, Dizygotic*