{"id":8646,"date":"2026-09-21T15:55:52","date_gmt":"2026-09-21T13:55:52","guid":{"rendered":"https:\/\/juanacrespo.com\/?post_type=caso&#038;p=8646"},"modified":"2026-09-22T09:30:46","modified_gmt":"2026-09-22T07:30:46","slug":"twin-pregnancy-using-own-oocytes-following-repeated-implantation-failures","status":"publish","type":"caso","link":"https:\/\/juanacrespo.com\/en\/case\/twin-pregnancy-using-own-oocytes-following-repeated-implantation-failures\/","title":{"rendered":"A successful twin pregnancy using the patient\u2019s own oocytes following repeated implantation failures and a previous egg donation"},"content":{"rendered":"<div>\n<h2><strong>Abstract<\/strong><\/h2>\n<ul>\n<li>Patient Profile: A 25-year-old woman with a history of infertility secondary to tubal\/pelvic factors and recurrent <a href=\"https:\/\/juanacrespo.com\/en\/problem\/implantation-failure\/\" target=\"_blank\" rel=\"noopener\">implantation failure<\/a>.<\/li>\n<\/ul>\n<ul>\n<li>Medical History: 2 ectopic pregnancies, 1 biochemical pregnancy, 1 early miscarriage, 3 unsuccessful cycles of <a href=\"https:\/\/juanacrespo.com\/cuales-son-las-fases-de-la-estimulacion-ovarica\/\" target=\"_blank\" rel=\"noopener\">ovarian stimulation<\/a> and multiple previous failed cycles of <a href=\"https:\/\/juanacrespo.com\/en\/treatment\/egg-donation\/\" target=\"_blank\" rel=\"noopener\">egg donation<\/a>.<\/li>\n<\/ul>\n<ul>\n<li>Diagnostic and Therapeutic Strategy:<\/li>\n<\/ul>\n<p style=\"padding-left: 80px;\">1. New course of ovarian stimulation with pre-implantation genetic testing for aneuploidy (PGT-A).<\/p>\n<p style=\"padding-left: 80px;\">2. Complementary pelvic magnetic resonance imaging (MRI) and <a href=\"https:\/\/juanacrespo.com\/histerosalpingografia-cuando-como-y-para-quien-esta-indicada\/\" target=\"_blank\" rel=\"noopener\">hysterosalpingography<\/a> (HSG).<\/p>\n<p style=\"padding-left: 80px;\">3. Reconstructive surgical <a href=\"https:\/\/juanacrespo.com\/tipos-de-histeroscopia-y-aplicaciones-en-reproduccion-asistida\/\" target=\"_blank\" rel=\"noopener\">hysteroscopy<\/a> and <a href=\"https:\/\/juanacrespo.com\/en\/technique\/revitalize\/\" target=\"_blank\" rel=\"noopener\">endometrial revitalisation<\/a> with platelet-rich plasma (PRP).<\/p>\n<ul>\n<li>Obstetric Outcome: <a href=\"https:\/\/juanacrespo.com\/en\/technique\/embryo-transfer\/\" target=\"_blank\" rel=\"noopener\">Embryo transfer<\/a> of two euploid embryos performed on 07\/07\/2026. Confirmation of a progressing dichorionic-biamniotic twin pregnancy (initial \u03b2-hCG: 234.94 mIU\/ml at 10 days post-transfer).<\/li>\n<\/ul>\n<\/div>\n<h2><\/h2>\n<div>\n<h2><strong>Reproductive history and medical history<\/strong><\/h2>\n<p>A 25-year-old patient referred to our specialist unit following a long history of unexplained infertility and multiple failures in assisted reproductive technology (ART) treatments.<\/p>\n<p>Previous obstetric history:<\/p>\n<ul>\n<li>Pregnancy losses: Two previous ectopic pregnancies, one biochemical pregnancy and one early first-trimester pregnancy loss.<\/li>\n<\/ul>\n<ul>\n<li>Previous Assisted Reproductive Technology (ART) treatments:<\/li>\n<\/ul>\n<p style=\"padding-left: 80px;\">&#8211; Three previous cycles of ovarian stimulation for <a href=\"https:\/\/juanacrespo.com\/en\/treatment\/in-vitro-fertilization\/\" target=\"_blank\" rel=\"noopener\"><i>In Vitro<\/i> Fertilisation (IVF)<\/a> using her own oocytes, without achieving a viable pregnancy.<\/p>\n<p style=\"padding-left: 80px;\">&#8211; Multiple cycles of embryo transfer using donated oocytes, with recurrent implantation failure.<\/p>\n<p>The medical history suggested not only a possible previous <a href=\"https:\/\/juanacrespo.com\/en\/problem\/poor-quality-eggs\/\" target=\"_blank\" rel=\"noopener\">oocyte<\/a> or embryo quality issue, but also an underlying, undiagnosed uterine or endometrial factor that was preventing successful implantation, regardless of the embryo\u2019s genetic origin.<\/p>\n<\/div>\n<h2><\/h2>\n<div>\n<div>\n<h2><strong>Multidisciplinary Treatment Strategy<\/strong><\/h2>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<p><img decoding=\"async\" class=\"alignnone wp-image-8648\" src=\"https:\/\/juanacrespo.com\/wp-content\/uploads\/2026\/09\/ingles-e1789732526123-300x186.png\" alt=\"\" width=\"726\" height=\"450\" srcset=\"https:\/\/juanacrespo.com\/wp-content\/uploads\/2026\/09\/ingles-e1789732526123-300x186.png 300w, https:\/\/juanacrespo.com\/wp-content\/uploads\/2026\/09\/ingles-e1789732526123-1024x635.png 1024w, https:\/\/juanacrespo.com\/wp-content\/uploads\/2026\/09\/ingles-e1789732526123-768x476.png 768w, https:\/\/juanacrespo.com\/wp-content\/uploads\/2026\/09\/ingles-e1789732526123-1536x953.png 1536w, https:\/\/juanacrespo.com\/wp-content\/uploads\/2026\/09\/ingles-e1789732526123.png 1586w\" sizes=\"(max-width: 726px) 100vw, 726px\" \/><\/p>\n<p>&nbsp;<\/p>\n<div>\n<div>\n<h1><strong>Step 1: Personalised stimulation and <a href=\"https:\/\/juanacrespo.com\/en\/technique\/pgt\/\" target=\"_blank\" rel=\"noopener\">genetic testing of the embryos<\/a><\/strong><\/h1>\n<p>In February 2026, it was decided to carry out a new individualised controlled ovarian stimulation (COS) cycle with the aim of obtaining blastocysts and assessing their chromosomal ploidy via PGT-A (Preimplantation Genetic Testing for Aneuploidy).<\/p>\n<ul>\n<li>Outcome of the stimulation protocol: Excellent follicular response with the retrieval of 31 oocytes.<\/li>\n<\/ul>\n<ul>\n<li>Embryo development in extended culture: Nine blastocysts of sufficient quality for trophoblast-dermal biopsy were obtained.<\/li>\n<\/ul>\n<ul>\n<li>PGT-A results: Six chromosomally normal (euploid) embryos were identified.<\/li>\n<\/ul>\n<p>This finding confirmed that the patient retained an adequate ovarian reserve and optimal intrinsic reproductive potential, shifting the primary clinical suspicion towards the recipient (uterine\/endometrial factor).<\/p>\n<h1><strong>Step 2: Endometrial\/Uterine Mapping and Anatomical Diagnosis<\/strong><\/h1>\n<p>The morphological assessment of the pelvis was completed using:<\/p>\n<p>Pelvic Magnetic Resonance Imaging (MRI): To rule out deep <a href=\"https:\/\/juanacrespo.com\/que-es-la-adenomiosis-sintomas-causas-y-posibles-tratamientos\/\" target=\"_blank\" rel=\"noopener\">adenomyosis<\/a>, M\u00fcllerian malformations or <a href=\"https:\/\/juanacrespo.com\/que-son-los-fibromas-uterinos-y-como-afectan-al-embarazo\/\" target=\"_blank\" rel=\"noopener\">subserosal\/intramural fibroids.<\/a><\/p>\n<p>Hysterosalpingography (HSG): To assess the architecture of the lower uterine segment and the sequelae of previous ectopic pregnancies.<\/p>\n<\/div>\n<\/div>\n<div>\n<h1><strong>Step 3: Surgical Correction and Endometrial Modulation<\/strong><\/h1>\n<ul>\n<li>Surgical Hysteroscopy: Resection and regularisation of the uterine cavity were performed to remove anatomical defects or adhesions (focal Asherman\u2019s syndrome).<\/li>\n<\/ul>\n<ul>\n<li>Endometrial Regenerative Medicine (PRP): Intrauterine instillation of platelet-rich plasma (autologous PRP) was administered to restore endometrial thickness, improve subendometrial vascularisation and optimise the implantation window.<\/li>\n<\/ul>\n<h1><strong>Step 4: Endometrial Preparation and Embryo Transfer<\/strong><\/h1>\n<p>Following histological recovery of the uterine cavity, endometrial preparation was initiated using oestrogen and micronised progesterone.<\/p>\n<ul>\n<li>Transfer Strategy: Two euploid blastocysts were transferred under direct transabdominal ultrasound guidance.<\/li>\n<\/ul>\n<h2><strong>Results and Clinical Course<\/strong><\/h2>\n<ul>\n<li>Confirmatory Blood Test (\u03b2-hCG): On 17\/07\/2026 (10 days post-transfer), the quantitative \u03b2-hCG blood test yielded a positive result of 234.94 mIU\/ml.<\/li>\n<li>Ultrasound Follow-up: The week 6\u20137 ultrasound scan confirmed the presence of two gestational sacs with yolk sacs and a detectable heartbeat (LCF+), leading to a diagnosis of a developing dichorionic-biamniotic twin pregnancy.<\/li>\n<\/ul>\n<h2><strong>Discussion and Clinical Conclusions<\/strong><\/h2>\n<p>This case demonstrates the importance of comprehensive diagnostic re-evaluation in young patients who have been prematurely labelled as having irreversible reproductive failure.<\/p>\n<p style=\"padding-left: 80px;\">1. Age vs. Oocyte Quality: Despite previous failed IVF cycles and the use of egg donation, the patient\u2019s biological age (25 years) ensured a high prognosis for embryonic euploidy following optimisation of the stimulation protocol.<\/p>\n<p style=\"padding-left: 80px;\">2. Relevance of the Uterine Factor in IRF: Implantation failure is not always embryonic in origin; surgical optimisation of the uterine cavity combined with regenerative therapies (PRP) is crucial for restoring endometrial receptivity.<\/p>\n<p style=\"padding-left: 80px;\">3. Indications for PGT-A: The selection of euploid embryos allows the implantation rate per transfer to be maximised and drastically reduces the time taken to achieve pregnancy.<\/p>\n<\/div>\n<p style=\"padding-left: 80px;\">\n","protected":false},"featured_media":8660,"template":"","meta":{"_acf_changed":false,"content-type":"","inline_featured_image":false},"categoria-de-caso":[466],"class_list":["post-8646","caso","type-caso","status-publish","has-post-thumbnail","hentry","categoria-de-caso-fallo-repetido-de-implantacion-fri"],"acf":[],"_links":{"self":[{"href":"https:\/\/juanacrespo.com\/en\/wp-json\/wp\/v2\/caso\/8646","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/juanacrespo.com\/en\/wp-json\/wp\/v2\/caso"}],"about":[{"href":"https:\/\/juanacrespo.com\/en\/wp-json\/wp\/v2\/types\/caso"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/juanacrespo.com\/en\/wp-json\/wp\/v2\/media\/8660"}],"wp:attachment":[{"href":"https:\/\/juanacrespo.com\/en\/wp-json\/wp\/v2\/media?parent=8646"}],"wp:term":[{"taxonomy":"categoria-de-caso","embeddable":true,"href":"https:\/\/juanacrespo.com\/en\/wp-json\/wp\/v2\/categoria-de-caso?post=8646"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}