Blood lymphocyte chimerism associated with IVF and monochorionic dizygous twinning: Case report
Blood lymphocyte chimerism associated with IVF and monochorionic dizygous twinning: Case report
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DOI：
10.1093/humrep/deh533
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发表时间：
2004-12-01
影响因子：
6.1
通讯作者：
Zori, RT
中科院分区：
文献类型：
--
作者：
Williams, CA;Wallace, MR;Zori, RT
我们报告了通过IVF和ICSI辅助孵化的双卵双胞胎，他们每个人的血液淋巴细胞中都有46，xx和46，xy细胞。这名女性双胞胎有轻微的生殖器异常，但进一步的研究显示其生殖解剖结构正常。颊、皮肤和卵巢组织的染色体和荧光原位杂交研究正常，颊组织DNA研究也正常。胎儿超声和胎膜病理与单绒毛膜双膜胎盘（MCDAP）一致。因此，这对双胞胎具有血液嵌合性，但在研究的其他组织中没有嵌合性。这种嵌合的机制可能是由于胎盘血管的吻合（在造血干细胞发育之后）或由于滋养细胞在囊胚发育早期的混合。这种滋养细胞混合物将被限制在胚胎外组织中，这样胎儿的一般身体发育是正常的，没有体细胞嵌合。该病例与先前报道的其他病例相结合表明，在试管婴儿受孕中，与双胞胎相关的血液嵌合的患病率以及与MCDAP相关的DZ双胞胎的发生率可能比之前认为的要高。
We report on dizygotic (DZ) twins, conceived by IVF and ICSI with assisted hatching, who each had a mixture of 46,XX and 46,XY cells in blood lymphocytes. The female twin had mild genitalia abnormalities but further study revealed anatomically normal reproductive anatomy. Chromosome and fluorescence in situ hybridization studies of buccal, skin and ovarian tissue were normal, as were buccal tissue DNA studies. Fetal ultrasound and fetal membrane pathology were consistent with a monochorionic, diamniotic placenta (MCDAP). These twins thus have blood chimerism but are not chimeric in the other tissues studied. The mechanism for the chimerism could be due to either placental vascular anastamoses (after the development of the haematoblast stem cells) or due to an admixture of trophoblast cells during early blastocyst development. Such trophoblast cell admixtures would be restricted to the extraembryonic tissues so that general physical development in the fetus is normal and without somatic cell chimerism. This case in combination with others previously reported suggests that in IVF conceptions, the prevalence of blood chimerism associated with twinning, and the occurrence of DZ twinning associated with MCDAP, may be higher than previously thought.