1/27. Twin pregnancy with a complete hydatidiform mole and co-existing fetus following in-vitro fertilization: case report.hydatidiform mole with a co-existing live fetus is a rare event. We report the case of a 41 year old Caucasian woman who attended for in-vitro fertilization. Three embryos, containing two apparently normal pronuclei, were transferred into the uterus. A twin pregnancy with a live fetus and a complete mole ensued. The pregnancy was managed conservatively until 28 weeks gestation when, following an episode of major antepartum haemorrhage, a live female infant was delivered by Caesarean section. The mole, weighing over 1.7 kg, was successfully evacuated. Following delivery, serum human chorionic gonadotrophin concentrations returned to baseline and remain within the normal range at 24 months. Both mother and daughter are well on assessment 24 months later.- - - - - - - - - - ranking = 1keywords = fertilization (Clic here for more details about this article) |
2/27. Repetitive complete hydatidiform mole can be biparental in origin and either male or female.Complete hydatidiform mole (CHM) is an abnormality in pregnancy due to a diploid conception which is generally androgenetic in origin, i. e. all 46 chromosomes are paternally derived. We have examined the genetic origin of repetitive hydatidiform moles in a patient having three CHM by two different partners, and no normal pregnancies. Using fluorescent microsatellite genotyping, we have shown all three CHM to be biparental, rather than androgenetic, in origin. Examination of informative markers for each homologous pair of chromosomes, in two of the CHM, failed to reveal any evidence of unipaternal disomy, suggesting that the molar phenotype might result from disruption of normal imprinting patterns due to a defect in the maternal genome. It has been suggested that intracytoplasmic sperm injection (ICSI), followed by selection of male embryos, can prevent repetitive CHM; but examination of sex chromosome-specific sequences in the three CHM described here, showed that, while two were female, the first CHM was male. Selection of male embryos is therefore unlikely to prevent repetitive CHM in this patient. Our results suggest that the genetic origin of repetitive CHM should be determined prior to in-vitro fertilization (IVF) and that current strategies for the prevention of repetitive CHM may not be appropriate where the CHM are of biparental origin.- - - - - - - - - - ranking = 0.22647106772494keywords = fertilization, conception (Clic here for more details about this article) |
3/27. molar pregnancy with a coexistent fetus after intracytoplasmic sperm injection. A case report.BACKGROUND: Normal fertilization is usually considered to have occurred when two pronculei (2PN) and two polar bodies are observed. Exceptions are the single pronucleated zygote resulting from asynchronous pronuclei. CASE: A 29-year-old woman entered a program of intracytoplasmic sperm injection and embryo transfer because of her husband's oligoasthenoteratozoospermia. Two cleavage-stage embryos (four blastomeres, grade 1 and 2) were obtained from one fertilized oocyte containing distinct 2PN and the other a single pronucleus (1PN). At 15 weeks' gestation the patient developed severe preeclampsia requiring termination of the pregnancy. Histopathologic examination and dna ploidy by image analysis were consistent with a twin pregnancy combining a complete hydatidiform mole and normal pregnancy. CONCLUSION: We hypothesize that this 1PN was at the origin of the hydatidiform mole. This case highlights the danger of transferring an embryo having 1PN.- - - - - - - - - - ranking = 0.2keywords = fertilization (Clic here for more details about this article) |
4/27. Molecular analysis of a gestation consisting of a complete hydatidiform mole and normal dizygotic twin.OBJECTIVE: To identify a twin pregnancy consisting of a complete mole and coexistent fetus by means of molecular cytogenetics and dna polymorphisms. STUDY DESIGN: Seven highly polymorphic dna markers were used to establish the androgenetic origin of a complete hydatidiform mole that coexisted with a normal 46,XY fetus. cytogenetic analysis of mole nuclei was performed with centromeric probes, demonstrating a 46,XX constitution. RESULTS: molar tissue was diploid with two X chromosomes, possibly due to chromosome doubling after monospermic fertilization of an ovum with inactivated or absent nucleus. CONCLUSION: Although contamination with maternal tissue may be difficult to avoid, molecular markers provide the possibility of distinguishing between a complete hydatidiform mole and coexisting normal fetus versus a partial mole, with methods that can be performed antenatally. This distinction is important since in the first case up to 24% of fetuses described in the literature have been viable, and the risk of subsequent development of persistent trophoblastic tumor in patients with a complete mole and a coexisting fetus is considerably higher than in patients with a single, complete hydatidiform mole.- - - - - - - - - - ranking = 0.2keywords = fertilization (Clic here for more details about this article) |
5/27. A case of twin pregnancy with complete hydatidiform mole and coexisting fetus following IVF-ET.Twin pregnancy consisting of complete hydatidiform mole (H-mole) and a coexisting fetus occurs with an estimated incidence of 1 per 22,000-100,000 pregnancies. The incidence of this unusual twin pregnancy with complete H-mole and a coexisting fetus after in vitro fertilization and embryo transfer (IVF-ET) is not thought to be greater than that of general population. We present an unusual twin pregnancy with complete H-mole and a coexisting fetus that occurred following IVF-ET, which was terminated at 21 weeks of gestation and developed into nonmetastatic gestational trophoblastic tumor.- - - - - - - - - - ranking = 0.2keywords = fertilization (Clic here for more details about this article) |
6/27. Complete hydatidiform mole and normal live birth: a novel case of confined placental mosaicism: case report.Hydatidiform molar change, characterized by abnormal fetoplacental development and placental villous trophoblast hyperplasia, results from genetically abnormal conception, in which there is an excess of paternally derived genetic material. The majority of pregnancies in which molar change has been reported in association with a live fetus represent dizygotic twin pregnancies in which one fertilization results in a complete hydatidiform mole (CM) and the other a normal co-twin. In such cases, there is usually a clear distinction, both sonographically and pathologically, between the molar and non-molar regions of the placenta. We present a singleton pregnancy, with diffuse placental molar change detected prenatally, which resulted in a chromosomally and phenotypically normal female infant at term. Pathological examination revealed the presence of intermixed populations of morphologically normal chorionic villi and villi with the characteristics of CM. Studies of genetic polymorphisms demonstrated that the CM, normal villi and fetus were all derived from the same sperm; the fetus was diploid and biparental whereas the areas of pathological CM were androgenetic and monospermic. We believe this represents the first well-documented case of apparent confined placental mosaicism involving CM and a coexisting normal fetus, which has presumably arisen following mitotic abnormalities in the early post-fertilization period.- - - - - - - - - - ranking = 0.42647106772494keywords = fertilization, conception (Clic here for more details about this article) |
7/27. Serial hCG and ultrasound measurements for predicting malignant potential in multiple pregnancies associated with complete hydatidiform mole: a report of 2 cases.BACKGROUND: Multiple pregnancy complicated by the presence of a complete hydatidiform mole (CHM) is a rare clinical entity. However, there are enough accumulated data to assist the clinician in the management of such a patient. CASES: Case 1 presented in the first trimester with a twin pregnancy associated with a CHM. In the absence of other complications, the pregnancy was monitored with serial beta-human chorionic gonadotropin (beta-hCG) and ultrasound measurements. A reduction in molar volume suggested regression of the CHM. The pregnancy was successfully carried to term with no progress of the CHM. Beta-hCG levels regressed after delivery. Case 2 had a triplet pregnancy resulting from in vitro fertilization with a CHM detected in the first trimester. Similar measurements were applied. The pregnancy was complicated by episodes of antepartum hemorrhage (APH). Further, the molar volume continued to increase. Because of recurrent APH, delivery was by cesarean section. After delivery, after an initial decline, the beta-hCG level rose, and pulmonary metastases were detected. The patient was treated with single-agent chemotherapy, with complete resolution. CONCLUSION: The combination of serial ultrasound molar volume measurements with serial beta-hCG estimation may assist the clinician in predicting which of these rare complicated pregnancies will result in the development of trophoblastic neoplasia.- - - - - - - - - - ranking = 0.2keywords = fertilization (Clic here for more details about this article) |
8/27. Intramural molar pregnancy: a case report.BACKGROUND: Intramural pregnancy is a rare but potentially life-threatening condition. The condition remains unknown to many clinicians and sonographers. With the ever-increasing use of high-resolution ultrasound scanning, early diagnosis of the condition is now possible, provided that the condition is thought of. To our knowledge, this is the first reported case of intramural pregnancy treated with suction evacuation under laparoscopic guidance. CASE: A 28-year-old woman presented with history of vaginal bleeding early in her fourth pregnancy, having had 2 previous suction terminations of pregnancy and evacuation of retained products of conception for incomplete miscarriage at 8 weeks' gestation 2 months earlier. An ultrasound scan showed a complex mass in the left fundal region of the uterus, and the serum beta-human chorionic gonadotropin levels were grossly elevated. The patient was found to have an intramural hyperplastic pregnancy, treated with suction evacuation under laparoscopic guidance and systemic methotrexate therapy. CONCLUSION: A macroscopic ostium led into the uterine cavity and made guided suction evacuation of the uterus possible. early diagnosis can prevent a life-threatening situation and conserve reproductive function.- - - - - - - - - - ranking = 0.026471067724941keywords = conception (Clic here for more details about this article) |
9/27. Partial hydatidiform mole following the transfer of single frozen-thawed embryo subsequent to ICSI.Hydatiform mole is a gestational trophoblastic disease characterized by the dominance of dispermic fertilization. micromanipulation techniques in assisted reproduction technologies have enabled direct evaluation of the zygotes and the formation of pronuclei in the zygote. Intracytoplasmic sperm injection (ICSI) of oocytes ensures that only a single spermatozoon enters the ooplasma. This study reports a case of partial hydatiform mole following the transfer of day 3 frozen-thawed embryo. ICSI was used as the assisted fertilization method because there was male factor infertility due to severe oligoasthenoteratozoospermia. Possible predisposing factors for partial hydatidiform mole after ICSI are also discussed.- - - - - - - - - - ranking = 0.4keywords = fertilization (Clic here for more details about this article) |
10/27. A case of triploidy.OBJECTIVE: To report a case of triploidy in a women who conceived after intracytoplasmic sperm injection (ICSI). DESIGN: Case report. SETTING: Maternity unit of a university hospital. PATIENT(S): A 29-year-old woman who was pregnant following intracytoplasmic sperm injection (ICSI). INTERVENTION(S): Ultrasound and serum screening. MAIN OUTCOME MEASURE(S): amniocentesis and postmortem findings. RESULT(S): amniocentesis confirmed the karyotype to be 69XXY, and the pregnancy was terminated. CONCLUSION(S): This case refers to diandric triploidy resulting from fertilization by diploid sperm.- - - - - - - - - - ranking = 0.2keywords = fertilization (Clic here for more details about this article) |
| | Next -> |