Successful quintuplet pregnancy of monochorionic male quadruplets and single female after double embryo transfer: case report and review of the literature.

OBJECTIVE

To report a rare case of quintuplets with monochorionic male quadruplets and a single female after two-blastocyst transfer.

DESIGN

Case report.

SETTING

University teaching hospital.

PATIENT(S): A 37-year-old gravida 1, para 1, presenting after two-embryo IVF with monochorionic male quadruplets and a single female.

INTERVENTION(S): Ultrasound examinations and cesarean delivery.

MAIN OUTCOME MEASURE(S): Successful delivery of five live-born infants at 28 weeks and 6 days of gestation for preterm labor.

RESULT(S): The patient was diagnosed with quintuplets consisting of monochorionic male quadruplets and a single female after the placement of two embryos in blastocyst stage. She was followed closely with ultrasound examinations and hospitalized at 23 weeks' gestation. Cesarean delivery was performed at 28 weeks and 6 days of gestation, with eventual discharge of all infants in healthy condition.

CONCLUSION(S): This case represents successful assisted reproductive technology quintuplets with monochorionic quadruplets and a co-sibling. Higher-order monozygotic pregnancies with monochorionic quadruplets are exceedingly rare and a potential complication of IVF.