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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

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



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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