Conjoined Twins Following Assisted Reproduction Technique

Abstract

The incidence of conjoined twins as reported in a worldwide epidemiological study is 1.47 per 100,000 births. It varies from 1 in 45,000-200,000 births. Conjoined twins following assisted reproduction are even rarer and we report one such case. A 36-year-old woman who conceived by intracytoplasmic sperm injection, was referred to the feto-maternal unit for nuchal translucency scan. A diagnosis of thoracopagus conjoined twins was made on ultrasound at 12 weeks 3 days of gestation. The couple was counseled in detail and they opted for termination. Pregnancy was terminated medically and the ultrasound diagnosis was confirmed. Assisted reproduction techniques involve a risk of conjoined twins and the present case report supports this. Early diagnosis of conjoined twins and determination of the type of fusion is possible. This aids in discussing the prognosis and counseling the couple regarding options of termination or continuation of pregnancy.

Conjoined Twins: Unicephalus Non-Janiceps Tetrapus Tetrabrachius

“…It is reported that the incidence varies between 1/50,000 and 1/200,000 in the United States and the highest incidence was observed in India (1/2,800) [1]. There is a female predominance in conjoined twins (70% female) [2,3], but our twins had male sex according to their external genitalia albeit we did not perform a genetic analysis. The pathophysiologic etiology of conjoined twins is still not fully understood, but two theories about its pathogenesis were suggested.…”

“…Conjoined twins are an uncommon form of monoamniotic twins, predicted to occur once in 50,000-100,000 births [1]. Female twins are more common than males [2,3]. They Council (number: 2021/135), the pregnancy was terminated.…”

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are classified according to the site of fusion followed by the Greek postfix "-pagus," meaning "fixed", as parapagus (28%), thoracopagus (19%), omphalopagus (18%), cephalopagus (11%), ischiopagus (11%), pygopagus (6%), craniopagus (5%) and rachipagus (< 1%) [3,4].It can be diagnosed in the 1st trimester or early 2nd trimester. Ultrasonographic findings are single placental mass, no intertwin membrane and contiguous skin covering the fetuses.

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“…are classified according to the site of fusion followed by the Greek postfix "-pagus," meaning "fixed", as parapagus (28%), thoracopagus (19%), omphalopagus (18%), cephalopagus (11%), ischiopagus (11%), pygopagus (6%), craniopagus (5%) and rachipagus (< 1%) [3,4].…”