Vanishing Twin Syndrome(VTS)---it’s a reality in IVF Patient.
Sehereen Sidiqua (BD), Sharmin Abbasi (BD)
[Sidiqua] Anwer Khan Modern Medical College Hospital, [Abbasi] Anwer Khan Modern Medic
Multiple pregnancy may occur from two or more fertilization events. After ART incidence inceases.Some times one of the fetus may be lost and it is called vanishing twin in early pregnancy. Before 12 weeks one or more embryo died in 36% of twin pregnancy,53% of triplet pregnancy and 65% when more than triplet.Here we present a case of vanishing twin Case: Our patient with 42 years old with secondary subfertility due to both tubal block and had reduced ovarian reserve. Ovulation induction given and on day 12 , 4 oocytes was aspirated and embryo transfer (ET) was performed on the 72 hour after aspiration.Three embryo was transferred.We gave her luteal support with micronized progesterone. On day 22 of embryo transfer we did a TVS and it showe three gestational sacs with good cardiac activity. During 14 weeks a routine USG done and it showed two fetus with good cardiac activity and one with no cardiac activity.WE did not take any intervention.Patient was in regular antenatal cheak-up with supportive therapy .And two live male and female babies delivered by elective C/S during 36 completed weeks.During routine examination of the placentas, a mummified fetus (fetus papyraceus) was found. Discussion: VTS is one of rare complication. Real spontaneous miscarriage. Unknowen aspects of pathogenesis exist, such as fetus papyraceus or the fetus may fully absorbed. Sometimes this condition may cause real spontaneous miscarriage of other fetuses. In modern ART technology double or single ET is encouraged to increase the successful outcome. Conclusion: Although numerous healty fetus deliverd in multiple pregnancy ,following ART but it is necessary to inform them about the risk of multiple pregnancy. So extra care should take when deal with multiple pregnancy.