OBJECTIVE: To report a genetically proved superfecundation of quintuplets after transfer of two embryos in IVF procedure and successful completion of the pregnancy after fetal reduction. DESIGN: Case report. SETTING: Academic reproductive medicine center. PATIENT(S): A 31-year-old woman, gravida 0, who underwent her second IVF cycle after three IUIs. INTERVENTION(S): After 5 years of primary infertility, three IUIs, and one IVF, the patient underwent her second IVF cycle with transfer of two fresh embryos on day 2. MAIN OUTCOME MEASURE(S): Development of five separate embryonic sacs. Fetal reduction to twins at 12 weeks of gestation. Successful pregnancy and delivery. Deoxyribonucleic acid analysis of the three reduced embryos, the live-born twins, and their parents. RESULT(S): Analysis of the seven DNA samples, because all were different, confirmed the superfecundation and disproved the zygote's division after transfer. Fetal growth restriction motivated preterm delivery by cesarean section. Both twins were in good health. CONCLUSION(S): Superfecundation can explain high-order multiple pregnancy and can be proved by DNA analysis. Couples must be informed because of the implications of fetal reduction for ethical issues, risks of pregnancy loss, fetal growth restriction, preterm delivery, and its consequences.
OBJECTIVE: To report a genetically proved superfecundation of quintuplets after transfer of two embryos in IVF procedure and successful completion of the pregnancy after fetal reduction. DESIGN: Case report. SETTING: Academic reproductive medicine center. PATIENT(S): A 31-year-old woman, gravida 0, who underwent her second IVF cycle after three IUIs. INTERVENTION(S): After 5 years of primary infertility, three IUIs, and one IVF, the patient underwent her second IVF cycle with transfer of two fresh embryos on day 2. MAIN OUTCOME MEASURE(S): Development of five separate embryonic sacs. Fetal reduction to twins at 12 weeks of gestation. Successful pregnancy and delivery. Deoxyribonucleic acid analysis of the three reduced embryos, the live-born twins, and their parents. RESULT(S): Analysis of the seven DNA samples, because all were different, confirmed the superfecundation and disproved the zygote's division after transfer. Fetal growth restriction motivated preterm delivery by cesarean section. Both twins were in good health. CONCLUSION(S): Superfecundation can explain high-order multiple pregnancy and can be proved by DNA analysis. Couples must be informed because of the implications of fetal reduction for ethical issues, risks of pregnancy loss, fetal growth restriction, preterm delivery, and its consequences.