Discordant Blood Chimerism in Dizygotic Monochorionic Laser-Treated Twin–Twin Transfusion Syndrome

Assaf, Samer; Randolph, Linda M.; Benirschke, Kurt; Wu, Sam; Samadi, Ramin; Chmait, Ramen H.

doi:10.1097/aog.0b013e3181e4bec7

Cited by 31 publications

(24 citation statements)

References 11 publications

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“…As in our case, the majority of those described previously have occurred in the context of infertility treatment with ovarian stimulation and artificial insemination i.e. IVF or IVF + ICSI [3,6,8,9,[11][12][13][14]16]. Typically numerous embryos were transferred simultaneously.…”

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confidence: 76%

“…To date 15 cases of monochorionic, dizygotic twins with chimerism have been described [3][4][5][6][7][8][9][10][11][12][13][14]. Most of these cases were blood chimerisms due to twin-twin transfusion in the presence of a common placenta [3,[5][6][7][8][10][11][12][13]; in this case chromosomal analysis of mucosa or skin biopsy is consistent with phenotypic sex. In the current case FISH was carried out on urothelium from both twins.…”

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confidence: 99%

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Antenatal Diagnosis of Dizygotic, Monochorionic Twins Following IVF/ICSI

Korsun

Bals‐Pratsch²,

Ortmann

et al. 2016

Geburtshilfe Frauenheilkd

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Abb. 1 Drei Embryonen im 6-bzw. 8-Zell-Stadium vor dem Embryotransfer (Kulturtag 3). Abb. 3 Sagittalschnitt des Körpers vom 1. Feten im Ultraschall mit Darstellung des Penis (siehe Pfeil). Abb. 4 Sagittalschnitt des Körpers vom 2. Feten im Ultraschall mit Darstellung der Klitoris (siehe Pfeil). Abb. 2 Bild der 1. Ultraschalluntersuchung in der 5 + 3 SSW zeigt eine Chorionhöhle mit 2 Dottersäcken.

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confidence: 76%

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confidence: 99%

Antenatal Diagnosis of Dizygotic, Monochorionic Twins Following IVF/ICSI

Korsun

Bals‐Pratsch²,

Ortmann

et al. 2016

Geburtshilfe Frauenheilkd

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“…Although various tissues other than blood derived from MCDZTs have been investigated in previous studies, none of these tissues demonstrated chimerism. [1][2][3][4][5] Previous reports thus concluded that chimerism is confined to blood cells and that clinical consequences of chimerism in other tissues would be minimal.…”

Section: Discussionmentioning

confidence: 99%

“…1 Miura et al and Assaf et al hypothesized that the fusion of outer cell masses at the morula stage between 2 eggs might be a cause of monochorionic dizygotes in artificial fertilization. 5,8 In either case, 2 fetuses might reside within close proximity when a single blastocyst with double inner masses is generated. In the present case, some cells derived from the 46,XX fetus could have migrated to the ectoderm of the 46,XY fetus when 2 inner cell masses are within close proximity, which later might have developed into the buccal membrane.…”

Section: Figurementioning

confidence: 99%

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Chimerism of Buccal Membrane Cells in a Monochorionic Dizygotic Twin

Fumoto¹,

Hosoi²,

Ohnìshì

et al. 2014

Pediatrics

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No monochorionic dizygotic twins (MCDZTs) with cellular chimerism involving cells other than blood cells have been reported in the literature to date. Here we report a probable first case of MCDZTs with buccal cell chimerism. A 32-year-old woman conceived twins by in vitro fertilization by using 2 cryopreserved blastocysts that were transferred into her uterus. An ultrasound scan at 8 weeks’ gestation showed signs indicative of monochorionic twins. A healthy boy and a healthy girl were born, showing no sexual ambiguity. Cytogenetic analyses and microsatellite studies demonstrated chimerism in blood cells of both twins. Notably, repeated fluorescence in situ hybridization and microsatellite studies revealed chimerism in buccal cells obtained from 1 of the twins. Although the mechanism through which buccal cell chimerism was generated remains to be elucidated, ectopic differentiation of chimeric hematopoietic cells that migrated to the buccal membrane or the cellular transfer between the 2 embryos at the early stage of development might be responsible for the phenomenon. This hypothesis raises an interesting issue regarding embryonic development and cellular differentiation into organs during fetal development. Given the possibility of cryptic chimerism in various organs including gonadal tissues in MCDZTs, close observation will be required to determine whether complications develop in the course of the patients’ growth.

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Chimerism in monochorionic dizygotic twins: Case study and review

Chen

Chmait

Vanderbilt

et al. 2013

American J of Med Genetics Pt A

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Chimerism occurs when an organism contains cells derived from more than one distinct zygote. We focus on monochorionic dizygotic twin blood chimerism, and particularly twin-twin transfusion syndrome in such pregnancies. For years, researchers have understood chimerism to be a common phenomenon in cattle. Although, this review will not delve deeply into animal chimerism, an understanding of chimerism in the animal world can provide clues regarding health implications for human chimeras. This report serves two purposes: an update and assessment of the twins we reported previously in 2010 [Assaf et al., 2010] and a review on dizygotic monochorionic chimeric twins. First, our updated assessment of the twins shows no identifiable regression of Müllerian sex derivatives in the female, and normal neurodevelopment was documented in both. Our research has suggested several key points; one that blood chimerism persists from fetal life to at least age two years. Second, chimerism in humans is not as rare as previously thought, although it has been studied only recently. Third, assisted reproductive technologies appear to increase the risk of monochorionic dizygotic twin pregnancies.

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Discordant Blood Chimerism in Dizygotic Monochorionic Laser-Treated Twin–Twin Transfusion Syndrome

Cited by 31 publications

References 11 publications

Antenatal Diagnosis of Dizygotic, Monochorionic Twins Following IVF/ICSI

Antenatal Diagnosis of Dizygotic, Monochorionic Twins Following IVF/ICSI

Chimerism of Buccal Membrane Cells in a Monochorionic Dizygotic Twin

Chimerism in monochorionic dizygotic twins: Case study and review

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