A case report of twin pregnancy with complete hydatidiform mole following two frozen-embryos subsequent to ICSI (Intracytoplasmic Sperm Injection)

Document Type : Case report

Authors

1 PhD in Reproductive Health, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran. Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.

2 Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran. M.Sc. in Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.

3 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Fellowship of Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technique for entering a sperm into the oocyte. In this study, a case of complete molar pregnancy which occurred following two frozen- embryo subsequent to ICSI was reported.
Case report: The patient was a 36 years pregnant woman with 5 weeks' gestation following the transfer of two embryos who referred to Armaghan Infertility Center in Mashhad in January 2020 complaining of severe vaginal bleeding. The 6 weeks ultrasonography found two gestational sacs, one with viable fetus and one massive and empty. At this time, β-hCG value was 40,000 IU/ml. Therefore, twin pregnancy was identified. Spotting continued for two weeks. B-hCG value was >100,000 IU/ml and ultrasound showed molar pregnancy and missed abortion. Therefore, with diagnosis of twin pregnancy with complete hydatidiform mole, the patient underwent suction curettage. Histological examination confirmed the diagnosis of complete hydatidiform mole.
Conclusion: Complete hydatidiform mole may happen after ICSI and this method cannot eliminate the incidence of molar pregnancy. Therefore, complete hydatidiform mole should be considered in pregnancy following ICSI which is associated with vaginal bleeding, large gestational sac and high serum β-hCG.

Keywords

References

  1. Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. The Lancet 2010; 376(9742):717-29.
  2. Jaffar RO, Kalsoom R, Quershi A. Histopathological review of partial and complete hydatidiform moles in a tertiary care hospital, Lahore. Pakistan. Biomedica 2011; 27(Jan.-Jun.):76-80.
  3. Kalogiannidis I, Kalinderi K, Kalinderis M, Miliaras D, Tarlatzis B, Athanasiadis A. Recurrent complete hydatidiform mole: where we are, is there a safe gestational horizon? Opinion and mini-review. Journal of assisted reproduction and genetics 2018; 35(6):967-73.
  4. Agrawal N, Sagtani RA, Budhathoki SS, Pokharel HP. Clinico-epidemiological profile of molar pregnancies in a tertiary care centre of Eastern Nepal: a retrospective review of medical records. Gynecologic Oncology Research and Practice 2015; 2(1):1-7.
  5. Rezavand N, Seyedzadeh SA. Study of hydatiform mole frequency and some relative risk factors. Avicenna Journal of Clinical Medicine 2009; 16(3):27-32.
  6. Merchant R, Gandhi G, Allahbadia GN. In vitro fertilization/intracytoplasmic sperm injection for male infertility. Indian Journal of Urology: IJU: Journal of the Urological Society of India 2011; 27(1):121.
  7. Hershlag A, Paine T, Kvapil G, Feng H, Napolitano B. In vitro fertilization-intracytoplasmic sperm injection split: an insemination method to prevent fertilization failure. Fertility and sterility 2002; 77(2):229-32.
  8. Kwon HE, Park EJ, Kim SH, Chae HD, Won HS, Kim CH, et al. A case of twin pregnancy with complete hydatidiform mole and coexisting fetus following IVF–ET. Journal of assisted reproduction and genetics 2002; 19(3):144-8.
  9. Sebire NJ. Prenatal diagnosis and management of twin pregnancies complicated by a co-existing molar pregnancy. Prenatal diagnosis 2006; 26(4):373-94.
  10. Pourali L, Ayati S, Vahidroodsari F, Javanmard M, Poursadrollah F. Incomplete molar pregnancy with live coexisting fetus: a case report. Tehran University Medical Journal 2014; 71(12):821-4.
  11. Alpay V, Kaymak D, Erenel H, Cepni I, Madazli R. Complete hydatidiform mole and co-existing live fetus after intracytoplasmic sperm injection: a case report and literature review. Fetal and pediatric pathology 2021; 40(5):493-500.
  12. Rao AR, Dafle K, Padmashri G, Rao DR, Sivakumar NC. Pregnancy outcome with coexisting mole after intracytoplasmic sperm injection: a case series. Journal of Human Reproductive Sciences 2015; 8(3):178-81.
  13. Dolapcioglu K, Gungoren A, Hakverdi S, Hakverdi AU, Egilmez E. Twin pregnancy with a complete hydatidiform mole and co-existent live fetus: two case reports and review of the literature. Archives of gynecology and obstetrics 2009; 279(3):431-6.
  14. Pourali L, Vatanchi A, Ayati S, Hamidi A, Zarei AA. Molar twin pregnancy with a live coexisting triple X fetus: Case report. Tehran University Medical Journal 2018; 76(1):74-8.
  15. Izadi-Mood N, Sarmadi S. Comparison of radiological and pathological results in gestational trophoblastic diseases. Tehran University Medical Journal 2013;71(6):356-62.
  16. Ulug U, Ciray NH, Tuzlali P, Bahçeci M. Case report: Partial hydatidiform mole following the transfer of single frozen–thawed embryo subsequent to ICSI. Reproductive BioMedicine Online 2004; 9(4):442-6.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 25, Issue 3
May 2022
Pages 119-124

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