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Unusual case of embryo implantation & superfetation

Catherine McDiarmid-Watt | Sunday, February 25, 2007 | 0 comments

Embryo implantation during menstruation in the absence of adequate estradiol and progesterone support, with subsequent normal response to ovulation induction and superfetation

Objective:
To report an unusual case of embryo implantation and superfetation.

Patient(s): A 41-year-old woman underwent two consecutive ovarian stimulation cycles interrupted by a normal menstrual period. Ovulation and implantation occurred during both cycles. The first embryo conceived developed normally until term; the second failed to develop.

Intervention(s): None.

Main Outcome Measure(s): Retrospective analysis of stored blood samples for serum E2, P, and β-hCG levels.

Result(s): Rising β-hCG levels during menstruation indicated normal embryonic implantation in the absence of adequate E2 and P support. During subsequent ovarian stimulation, there was a normal follicular and E2 response and normal ovulation in spite of the ongoing pregnancy. The second embryo, conceived during the second cycle of stimulation, implanted but failed to develop.

Conclusion(s): This unusual case indicates that E2, P, and endometrial thickness requirements for successful implantation may not always be as critical as postulated previously. The absence of a decidual response might have facilitated superfetation.

Source: Fertility and Sterility, Volume 68, Issue 3 , September 1997, Pages 538-541





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Catherine

About Catherine: I am mom to three grown sons, two grandchildren and two rescue dogs. After years of raising my boys as a single mom, I remarried a wonderful man who had never had a child of his own. Unexpectedly, I found myself pregnant at 49!
Sadly we lost that precious baby at 8 weeks, and decided to try again. Five more losses, turned down for donor egg, foster care and adoption due to my age and losses - we have accepted that there will be no more babies in our house.

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