Live birth of twins derived from zona-free oocytes

ObjectiveTo report a live birth of twins from autologous zona-free oocytes.DesignCase report.SettingReproductive endocrinology and infertility private practice and ambulatory in vitro fertilization (IVF) center.Patient(s)A 34-year-old woman, gravida 0, with 100% zona-free oocytes.Intervention(s)IVF with intracytoplasmic sperm injection (ICSI), blastocyst culture, and fresh embryo transfer.Main Outcome Measure(s)Fertilization, blastocyst development, and live birth.Result(s)A 34-year-old woman, gravida 0, conceived through IVF using autologous zona-free oocytes. The 11 retrieved oocytes were zona-free, from which eight were inseminated with ICSI; two embryos were transferred at morula and blastocyst stage, resulting in a twin pregnancy delivered at an estimated the gestational age of 37 weeks and 1 day.Conclusion(s)Patients with the rare condition of 100% zona-free oocytes maintain the potential for pregnancy after careful micromanipulation of the oocytes. Caution is recommended on the number of embryos selected for transfer to reduce the risk of multiple gestation.