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Case Report
Superfetation: A surrogate dilemma
1 ST4 in Obstetrics and Gynaecology, North East Deanery, 42 Canal Court, CA2 7AG, Carlisle, UK
2 ST1 in Obstetrics and Gynaecology, North East Deanery, UK
3 Medical Director, GCRM Fertility, Glasgow, UK
4 Consultant Obstetrician and Gynaecologist, South Tyneside and Sunderland NHS Foundation Trust, South Shields, UK
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Christos Spyroulis
ST4 in Obstetrics and Gynaecology, North East Deanery, 42 Canal Court, CA2 7AG, Carlisle,
UK
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Article ID: 100075Z08CS2021
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Spyroulis C, Naqvi K, Gaudoin M, Al-Inizi S. Superfetation: A surrogate dilemma. J Case Rep Images Obstet Gynecol 2021;7: 100075Z08CS2021.ABSTRACT
Introduction: Surrogacy is a method of reproductive medicine when a woman carries and gives birth to a baby for another person or couple. This gives an opportunity to the commissioning parents who cannot have their own child for different reasons to have a child by providing their genetic material which is then implanted into the uterus of the surrogate mother. There are certain situations where surrogacy is indicated such as women with a medical condition that makes it impossible or dangerous for them to be pregnant such as congenital absent or malformed uterus, recurrent pregnancy loss and repeated in vitro fertilization (IVF) implantation failure. It is also a popular option for male same-sex couples and can be used by people who are single. Unquestionably it is a gift to couples who cannot have their own child and do not want to undergo adoption. However, there are numerous ethical, moral, and legal implications in theses pregnancies in addition to the fact that different national laws govern surrogacy across the world.
Case Report: We present a case of a 25-year-old surrogate mother, who had a single blastocyst transfer from a commissioning couple. She did not follow the instructions of abstaining from intercourse during the IVF cycle as advised by the IVF unit. She conceived with diamniotic dichorionic (DADC) twins of different gender. This made the whole situation complicated but interesting, since she turned out to be the biological mother of the female twin. These series of events gave rise to several ethical, emotional, and legal issues such as parentage, monetary compensation, and the impact of unintended pregnancy on the couples.
Conclusion: To our best knowledge, this is the first reported case of surrogate pregnancy carrying twins resulting from superfetation following single blastocyst transfer.
Keywords: DADC twins, Ethical dilemma, Superfetation, Surrogacy
SUPPORTING INFORMATION
Author Contributions
Christos Spyroulis - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Khadeeja Naqvi - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Marco Gaudoin - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Al-Inizi Shamma - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Christos Spyroulis et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
