Dados do Trabalho

Title

Case report of assisted hatching (AH) and multiple pregnancy.

Objective

To report a case of in vitro fertilization (IVF), with transfer of 2 embryos resulting in clinical pregnancy with 4 gestational sacs.

Methods

Case report description from a fertility clinic in São Paulo, Brazil.

Results

Couple with infertility for 12 months with male factor (idiopathic oligoasthenozoospermia). Intracytoplasmic sperm injection (ICSI) was performed and all embryos were frozen, with delayed transfer due to risk of ovarian hyperstimulation syndrome. Due to thickening of zona pellucida and unfavorable laboratory outcome in previous cycle, AH was performed. Two thawed embryos were transferred at the cleavage stage with positive pregnancy test. In the 7th week, four gestational sacs were identified, all with yolk sac and embryonic pole with present cardiac activity. In the 1st trimester ultrasound, a twin pregnancy and missed abortion were observed in two gestational sacs.

Conclusion

Although AH is not routinely indicated, some laboratories use it in selected cases due to thickening of zona pellucida or for embryonic biopsy. Patients should be informed about the possibility of embryonic cleavage and development of multiple pregnancies, with their associated risks. The case corroborates the literature as there is evidence of assisted hatching and increased incidence of multiple pregnancies.

Keywords

IVF, assisted hatching, multiple pregnancy.