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Identification of a hydatidiform mole in twin pregnancy following assisted reproduction

  • Assisted Reproduction Technologies
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Abstract

Purpose

The aim of this study was to identify a co-existing hydatidiform mole (HM) in twin pregnancy from the abnormal mixed-genomic products of conception (POC) after assisted reproduction by histopathological review, evaluation of p57kip2 immunostaining and short tandem repeat genotyping.

Methods

Thirty-seven patients were collected with suspicion for HM by pathological morphology. They had two embryos individually transferred to their uterus after in vitro fertilization and presented two gestational sacs with undeveloped embryos or one sac with an abnormal area by ultrasonography.

Results

Thirty patients were diagnosed as singleton pregnancy, including twenty-two non-molar gestations, six trisomy gestations, one homozygous complete mole and one heterozygous partial mole. Although six patients had ultrasonic imaging of two gestational sacs, the embryonic components in the vacant sac might fade away after transferring. Other seven patients were considered as twin pregnancy by the allelic genotype from two individual conceptions. For the patients with uniform p57kip2 positivity, excessive paternal alleles indicated the potential partial HM in the twin pregnancy. For the patients demonstrated divergent and/or discordant p57kip2 immunostaining, twin pregnancy with co-existing complete HM or mosaic conception were confirmed by genotyping of different villi population respectively. These patients were monitored by serum β-HCG, while one twin pregnancy with complete mole suffered invasive mole and received chemotherapy.

Conclusions

A strategy composed of selective clinicopathological screening, immunohistochemical interpretation and accurate genotyping is recommended for diagnostically challenging mixed-genomic POC of potential twin pregnancy with HM, especially to differentiate a non-molar mosaic conception from a partial mole.

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Contributions

Yan Liu played a major role in data collection and overview, interpreted the data of genotyping and immunochemistry, edited and revised the manuscript for intellectual content.

Xingzheng Zheng played a major role in data collection, interpreted the data of genotyping, and revised the manuscript for intellectual content.

Yuxiang Wang played a major role in pathological review, interpreted the data of immunochemistry, and revised the manuscript for intellectual content.

Yan Li played a major role in the molecular genotyping and immunochemistry experiments.

Congrong Liu played a major role in pathological review, interpreted the data, and revised the manuscript for intellectual content.

All authors approved the submitted manuscript and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Funding

This project was funded by the following sources:

1. National Key Research and Development Program of China, Contract grant number: 2018YFC1004000.

2. Leading Academic Discipline Project of Beijing Education Bureau, Contract grant number: BMU20110254.

Author information

Authors and Affiliations

  1. Department of Pathology, School of Basic Medical Sciences, Third Hospital, Peking University Health Science Center, Beijing, 100191, China

    Yan Liu, Yuxiang Wang, Yan Li & Congrong Liu

  2. Department of Pathology, Capital Medical University Beijing Obstetrics and Gynecology Hospital, Beijing, 100123, China

    Xingzheng Zheng

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  1. Yan Liu
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Correspondence to Yan Liu or Congrong Liu.

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"The use of patient data for the present study has been approved by the local ethical committee. A written consent form was signed by each patient.

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The authors declare that they have no conflict of interest.

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Liu, Y., Zheng, X., Wang, Y. et al. Identification of a hydatidiform mole in twin pregnancy following assisted reproduction. J Assist Reprod Genet 37, 603–610 (2020). https://doi.org/10.1007/s10815-019-01650-3

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  • DOI: https://doi.org/10.1007/s10815-019-01650-3

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