2013, Number 3
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Rev Mex Med Repro 2013; 5.6 (3)
Dichorionic-diamniotic monozygotic twins: understanding its physiopathogenics thanks to assisted reproduction techniques
Cervantes E, Vela G, Sandler B, Vallejo V, Copperman A, Luna M
Language: Spanish
References: 15
Page: 142-148
PDF size: 169.99 Kb.
ABSTRACT
Twinning has fascinated human beings over the centuries. It is
well recognized that this condition is increased after assisted
reproductive techniques and several factors have been identified
that appear to predispose patients to this phenomenon. The
majority of twins that occur with assisted reproductive techniques
are dizygotic and are a direct result of a multi-embryo transfer.
Monozygotic twins, however, appear to also be increased.
Traditional dogma suggests that if division of the embryo takes
place during the cleavage stage (day 1-3), the monozygotic
twins implant themselves separately (after the
zona pellucida
has disappeared), similar to dizygotic twins. Each twin thus has
its own placenta, its own chorion and amnion. In the majority of
the cases, the division occurs in the blastocyst stage (day 4-8).
In these cases, the embryonic bud divides itself in the interior
of the same blastocyst cavity into two masses of cells. Both
embryos possess the same chorion and the same placenta, but
each has its own amnion. If this process occurs afterwards (day
8-12) monochorionic-monoamniotic twins develop. Theoretically,
the day the embryo splits will regulate the chorionicity and
amnionicity of the pregnancy. Our series of cases, however, do
not concur with this dogma. We observed late embryonic splits
that resulted in monozygotic pregnancies with two chorions
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