Are Monochorionic Twins More Likely Subsequent to Blastocyst Transfer? A Case Report and Experience With the “German Middle Way”
Bibliographic record
Abstract
Since the introduction of assisted reproductive techniques the amounts of monozygotic twins (MZTs) have been rising. Several studies have suggested that blastocyst culture and the associated prolonged in vitro cultivation time might play a role in the manifestation of monochorionic twins. Due to the recent changes in the interpretation of the German Embryo Protection Act, it became accepted for patients and doctors in some regions of Germany to select for the most suitable embryo prior to implantation, referred to as the “German middle way”. We report a rare case of two sets of monochorionic and diamniotic twins subsequent to blastocyst transfer. A missed abortion of one of the twin sets occurred at the eighth week of gestation. The ongoing pregnancy showed no further signs of pathology and two healthy twins were delivered per cesarean section at 38 weeks. This case demonstrates that patients should be well informed concerning the risk for monochorionic twins subsequent to blastocyst transfer. In our experience, however, blastocyst transfer on day 5 does not seem to increase the risk for monochorionic twins compared to in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) with transfer on day 2. J Clin Gynecol Obstet. 2014;3(3):114-116 doi: http://dx.doi.org/10.14740/jcgo274w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".