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Navydoc
ParticipantJust found a neat case report of a monochorionic/triamniotic triplet pregnancy after IVF. This particular configuration could only occur after 2 twinning events in the same embryo. In the case 2 embryos were transferred, but only one survived and implanted.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=12906712
ParticipantJust found a neat case report of a monochorionic/triamniotic triplet pregnancy after IVF. This particular configuration could only occur after 2 twinning events in the same embryo. In the case 2 embryos were transferred, but only one survived and implanted.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=12906712
ParticipantJust found a neat case report of a monochorionic/triamniotic triplet pregnancy after IVF. This particular configuration could only occur after 2 twinning events in the same embryo. In the case 2 embryos were transferred, but only one survived and implanted.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=12906712
Participant[quote=no_such_reality]Navydoc, you didn’t say anything.
What is the probability an embryo splits? 32 out of 1000? That’s one, two concurrent splits?
[/quote]
The answer to your question is not completely known. The chance of a spontaneous embryo splitting in a natural pregnancy is 0.42%, but, as we all know, this is anything but a natural pregnancy. I also can’t meaningfully respond without knowing more about her specific IVF procedure. Twinning rates are higher if intracytoplasmic sperm injection was used to make the embryos, a real possibility, since in this case she used donor sperm. When a patient conceived via IVF we always get a report from the REI staing how many embryos were transferred, and I agree, 2 splitting events simultaneously would be unusual, just not impossible.
Much of the work in IVF is focused on making the best posssible embryo quality, and unfortunately, we often don’t know what will happen until after the fact.
Participant[quote=no_such_reality]Navydoc, you didn’t say anything.
What is the probability an embryo splits? 32 out of 1000? That’s one, two concurrent splits?
[/quote]
The answer to your question is not completely known. The chance of a spontaneous embryo splitting in a natural pregnancy is 0.42%, but, as we all know, this is anything but a natural pregnancy. I also can’t meaningfully respond without knowing more about her specific IVF procedure. Twinning rates are higher if intracytoplasmic sperm injection was used to make the embryos, a real possibility, since in this case she used donor sperm. When a patient conceived via IVF we always get a report from the REI staing how many embryos were transferred, and I agree, 2 splitting events simultaneously would be unusual, just not impossible.
Much of the work in IVF is focused on making the best posssible embryo quality, and unfortunately, we often don’t know what will happen until after the fact.
Participant[quote=no_such_reality]Navydoc, you didn’t say anything.
What is the probability an embryo splits? 32 out of 1000? That’s one, two concurrent splits?
[/quote]
The answer to your question is not completely known. The chance of a spontaneous embryo splitting in a natural pregnancy is 0.42%, but, as we all know, this is anything but a natural pregnancy. I also can’t meaningfully respond without knowing more about her specific IVF procedure. Twinning rates are higher if intracytoplasmic sperm injection was used to make the embryos, a real possibility, since in this case she used donor sperm. When a patient conceived via IVF we always get a report from the REI staing how many embryos were transferred, and I agree, 2 splitting events simultaneously would be unusual, just not impossible.
Much of the work in IVF is focused on making the best posssible embryo quality, and unfortunately, we often don’t know what will happen until after the fact.
Participant[quote=no_such_reality]Navydoc, you didn’t say anything.
What is the probability an embryo splits? 32 out of 1000? That’s one, two concurrent splits?
[/quote]
The answer to your question is not completely known. The chance of a spontaneous embryo splitting in a natural pregnancy is 0.42%, but, as we all know, this is anything but a natural pregnancy. I also can’t meaningfully respond without knowing more about her specific IVF procedure. Twinning rates are higher if intracytoplasmic sperm injection was used to make the embryos, a real possibility, since in this case she used donor sperm. When a patient conceived via IVF we always get a report from the REI staing how many embryos were transferred, and I agree, 2 splitting events simultaneously would be unusual, just not impossible.
Much of the work in IVF is focused on making the best posssible embryo quality, and unfortunately, we often don’t know what will happen until after the fact.
Participant[quote=no_such_reality]Navydoc, you didn’t say anything.
What is the probability an embryo splits? 32 out of 1000? That’s one, two concurrent splits?
[/quote]
The answer to your question is not completely known. The chance of a spontaneous embryo splitting in a natural pregnancy is 0.42%, but, as we all know, this is anything but a natural pregnancy. I also can’t meaningfully respond without knowing more about her specific IVF procedure. Twinning rates are higher if intracytoplasmic sperm injection was used to make the embryos, a real possibility, since in this case she used donor sperm. When a patient conceived via IVF we always get a report from the REI staing how many embryos were transferred, and I agree, 2 splitting events simultaneously would be unusual, just not impossible.
Much of the work in IVF is focused on making the best posssible embryo quality, and unfortunately, we often don’t know what will happen until after the fact.
Participant[quote=no_such_reality]Child protective services needs to take the children away for their own good.
As for the six implants, I suspect it’s bunk when we really dig in. The probability of two of the six splitting seems pretty remote.
[/quote]
You may think it’s remote, but you’d be wrong. Every identical twin is a split single embryo. If it splits between 0-3 days the twins each have their own sac and placenta, 4-8 days they share a placenta, but have their own bag, 8-12 the are both in the same bag, after 12 days they are conjoined (Siamese). The later the split occurs the more complicated the pregnancy is. Every reproductive endocrinologist is aware of the risk of splitting embryos. I myself diagnosed quads in someone who I know only had 3 emryos implanted, because my friend did it. The Navy only allows a maximum of 3 embryos to be implanted.
If you know or have known any sets of identical twins they are certainly from split embryos. And don’t forget, it is quite possible our patinet had 4 of the embryos split to form 4 sets of identical twins.
Participant[quote=no_such_reality]Child protective services needs to take the children away for their own good.
As for the six implants, I suspect it’s bunk when we really dig in. The probability of two of the six splitting seems pretty remote.
[/quote]
You may think it’s remote, but you’d be wrong. Every identical twin is a split single embryo. If it splits between 0-3 days the twins each have their own sac and placenta, 4-8 days they share a placenta, but have their own bag, 8-12 the are both in the same bag, after 12 days they are conjoined (Siamese). The later the split occurs the more complicated the pregnancy is. Every reproductive endocrinologist is aware of the risk of splitting embryos. I myself diagnosed quads in someone who I know only had 3 emryos implanted, because my friend did it. The Navy only allows a maximum of 3 embryos to be implanted.
If you know or have known any sets of identical twins they are certainly from split embryos. And don’t forget, it is quite possible our patinet had 4 of the embryos split to form 4 sets of identical twins.
Participant[quote=no_such_reality]Child protective services needs to take the children away for their own good.
As for the six implants, I suspect it’s bunk when we really dig in. The probability of two of the six splitting seems pretty remote.
[/quote]
You may think it’s remote, but you’d be wrong. Every identical twin is a split single embryo. If it splits between 0-3 days the twins each have their own sac and placenta, 4-8 days they share a placenta, but have their own bag, 8-12 the are both in the same bag, after 12 days they are conjoined (Siamese). The later the split occurs the more complicated the pregnancy is. Every reproductive endocrinologist is aware of the risk of splitting embryos. I myself diagnosed quads in someone who I know only had 3 emryos implanted, because my friend did it. The Navy only allows a maximum of 3 embryos to be implanted.
If you know or have known any sets of identical twins they are certainly from split embryos. And don’t forget, it is quite possible our patinet had 4 of the embryos split to form 4 sets of identical twins.
Participant[quote=no_such_reality]Child protective services needs to take the children away for their own good.
As for the six implants, I suspect it’s bunk when we really dig in. The probability of two of the six splitting seems pretty remote.
[/quote]
You may think it’s remote, but you’d be wrong. Every identical twin is a split single embryo. If it splits between 0-3 days the twins each have their own sac and placenta, 4-8 days they share a placenta, but have their own bag, 8-12 the are both in the same bag, after 12 days they are conjoined (Siamese). The later the split occurs the more complicated the pregnancy is. Every reproductive endocrinologist is aware of the risk of splitting embryos. I myself diagnosed quads in someone who I know only had 3 emryos implanted, because my friend did it. The Navy only allows a maximum of 3 embryos to be implanted.
If you know or have known any sets of identical twins they are certainly from split embryos. And don’t forget, it is quite possible our patinet had 4 of the embryos split to form 4 sets of identical twins.
Participant[quote=no_such_reality]Child protective services needs to take the children away for their own good.
As for the six implants, I suspect it’s bunk when we really dig in. The probability of two of the six splitting seems pretty remote.
[/quote]
You may think it’s remote, but you’d be wrong. Every identical twin is a split single embryo. If it splits between 0-3 days the twins each have their own sac and placenta, 4-8 days they share a placenta, but have their own bag, 8-12 the are both in the same bag, after 12 days they are conjoined (Siamese). The later the split occurs the more complicated the pregnancy is. Every reproductive endocrinologist is aware of the risk of splitting embryos. I myself diagnosed quads in someone who I know only had 3 emryos implanted, because my friend did it. The Navy only allows a maximum of 3 embryos to be implanted.
If you know or have known any sets of identical twins they are certainly from split embryos. And don’t forget, it is quite possible our patinet had 4 of the embryos split to form 4 sets of identical twins.
ParticipantHe wouldn’t need privileges at Kaiser. They dont get involved until AFTER she is pregnant. The typical MO for an infertility specialist is to help the patient conceive, then she goes and finds her own obstetrician and the infertility doc is not involved in the prenatal care at all. In fact it is my experience when an REI (repro-endo-infertility) doc takes over a labor and delivery board they get a decided “deer in the headlights” look. L&D ain’t for everyone.
I generally have a great deal of respect for reproductive endocrinologists; they care for a traditionally difficult patient population, and have achieved amazing things in recent years. Having been an infertility patient myslf, I know how challenging this diagnosis is. That being said, few things in OB/GYN have caused as much trouble as infertility treatment, and the more babies there are, the more trouble you can expect. The gestational age she achieved is absolutely miraculous with 8 fetuses. I’d be impressed if she only had triplets and she delivered at 30+ weeks. As I stated in my previous post, few very high order gestations make it to viability. I have delivered PLENTY of pre-viable multiples only to have the infants survive a few hours, and a have a tear-stained patient go home the next day. Another complication with this many embryos is a potentially life-threatening over-stimulation of the ovaries. As an earlier poster said “she should get punched in the ovaries”. I assure you, she already has been.
I am not too surprised our doctor in this case is not board certified, but I wouldn’t read that much into it, as neither am I yet. I still have to pass my general OB/GYN oral boards, and my Maternal Fetal Medicine boards, both will hopefully be completed in the next 2 years. It takes an incredibly long time to become a doctor, and even longer if you want to subspecialize.
Having known something of this woman prior to delivery, I absolutely knew she was going to devolve very quickly from media sensation to pariah. I’m just so sorry the California taxpayers get to pay the bills. I guess I’m glad I don’t pay California taxes.
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