[Tubal pregnancy and superfetation. The superfetation will or will not be extra-uterine].
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A twin case of disputed paternity with probable superfetation is reported. The putative father could be excluded as the father of Twin F by HLA, GLO, and Ss typing results, but could not be excluded as the father of Twin S, with a probability of paternity for this twin of 99.995%. A birth weight difference of 450 g and the evidence for additional sexual intercourses by the mother suggest the very rare event of a superfetation.
OBJECTIVE: To report an unusual case of embryo implantation and superfetation. DESIGN: Retrospective case analysis. SETTING: Oak Brook Fertility Center. PATIENT(S): A 41-year-old woman underwent two consecutive ovarian stimulation cycles interrupted by a normal menstrual period. Ovulation and implantation occurred during both cycles. The first embryo conceived developed normally until term; the second failed to develop. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Retrospective analysis of stored blood samples for serum E2, P, and beta-hCG levels. RESULT(S): Rising beta-hCG levels during menstruation indicated normal embryonic implantation in the absence of adequate E2 and P support. During subsequent ovarian stimulation, there was a normal follicular and E2 response and normal ovulation in spite of the ongoing pregnancy. The second embryo, conceived during the second cycle of stimulation, implanted but failed to develop. CONCLUSION(S): This unusual case indicates that E2, P, and endometrial thickness requirements for successful implantation may not always be as critical as postulated previously. The absence of a decidual response might have facilitated superfetation.
A 20-year-old primigravida initially diagnosed at 28 weeks to have superfetation in a case of a bicornuate uterus was subsequently found to have uterus pseudo didelphys during a cesarean section at 35 weeks. This type of uterine anomaly with twin gestation has been previously reported in five case reports, but superfetation with such müllerian abnormality has not been previously described.
This observation reports a case of human superfetation. Fertilizable oocytes and embryos were obtained after ovarian stimulation in a women already several weeks pregnant. Spontaneous monofetal pregnancy had normal development and the embryos obtained after in vitro fertilization were actually frozen.
In this paper a bibliography on superfecundation and superfetation phenomena and the author's opinion on the subject was presented.
There was only one embryo transferred to the recipient female. There was no chance for natural service to occur from 21 days prior to the transfer of the embryo to 31 days after the transfer of the 7 day old blastocyst. The surrogate female was palpated as being 38 days pregnant 31 days after the transfer of a 7 day old embryo by an experienced professional before being exposed to the natural service sire. The second fetus was of a different sex than the first and was approximately 60 days less mature. All other pregnancies within this well managed herd were accounted for and no other cows calved within the area close to that time. The remaining recipients carried pregnancies to the approximate expected calving date. Conclusion. This case report should support earlier evidence that superfetation in the bovine can and does occur.
A case of superfetation is reported. A 23 year old gravida 3, para 1, aborta 1 had a D & C and partial left salpingectomy for ruptured left tubal pregnancy. The microscopic examination of the curettings and the left fallopian tube revealed two pregnancies. The tubal pregnancy was obviously older than the intra-uterine pregnancy and the two fertilized eggs had to result from different ovulations.
We report the case of a dichorionic and diamniotic pregnancy with the unique feature of an early ultrasound diagnosis of a 4-week size difference, which persisted throughout pregnancy. At birth, the twins had a 1-month difference in physical and neurological maturity. We believe that only the phenomenon of a superfetation can explain this difference. We report the cases found in the literature.
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