Monozygotic multiple gestation following in vitro fertilization: analysis of seven cases from Japan

  • Atsushi Yanaihara
  • Takeshi Yorimitsu
  • Hiroshi Motoyama
  • Hideaki Watanabe
  • Toshihiro Kawamura
Open Access
Case Report


We present a series of monozygous multiple gestations achieved following in vitro fertilization (IVF): one case of monochorionic triplet pregnancy and six cases of dizygotic triplet pregnancy. From September 2000 to December 2006, all patients achieving clinical pregnancy by ART were reviewed (n = 2433). A 37 year-old woman who delivered a healthy singleton after IVF returned two years later for FET, and a single blastocyst was transferred. This also resulted in pregnancy, but TV-USG revealed a single gestational sac with three distinct amniotic sacs, each containing a distinct fetal pole with cardiac activity. This pregnancy was electively terminated at nine weeks' gestation. An additional six cases of dizygotic triplets established after fresh embryo transfer (no ICSI or assisted hatching) are also described. Of these, one resulted in a miscarriage at eight weeks' gestation and five patients have an ongoing pregnancy. This case series suggests the incidence of dizygotic/monochorionic triplets following IVF is approximately 10 times higher than the expected rate in unassisted conceptions, and underscores the importance of a conservative approach to lower the number of embryos at transfer. The role of embryo transfer technique and in vitro culture media in the twinning process requires further study.



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Copyright information

© Yanaihara et al; licensee BioMed Central Ltd. 2007

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Authors and Affiliations

  • Atsushi Yanaihara
    • 1
    • 2
  • Takeshi Yorimitsu
    • 1
  • Hiroshi Motoyama
    • 1
  • Hideaki Watanabe
    • 1
  • Toshihiro Kawamura
    • 1
  1. 1.Denentoshi Ladies Clinic Reproductive CenterYokohama-shi, KanagawaJapan
  2. 2.Department of Obstetrics and GynecologyShowa University School of MedicineShinagawa-ku, TokyoJapan

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