Molar pregnancy after in vitro fertilization with euploid single embryo transfer

OBJECTIVE: To describe a case of molar pregnancy after in vitro fertilization (IVF) resulting from the transfer of a euploid embryo derived from a monopronuclear zygote. DESIGN: Case report and review of the literature. SETTING: Private practice IVF center. PATIENT(S): A 42-year-old woman, gravida 3 para 0, with advanced maternal age and infertility who underwent IVF. INTERVENTION(S): Preimplantation genetic testing for aneuploidy using next-generation sequencing, single frozen euploid blastocyst transfer, and medical management of suspected missed abortion. MAIN OUTCOME MEASURE(S): Genetic examination of products of conception and correlation with embryonic preimplantation genetic testing for aneuploidy results. RESULT(S): Transfer of the euploid embryo derived from an abnormally fertilized oocyte (monopronuclear zygote) resulted in a clinical pregnancy suspected to be a missed abortion. Products of conception collected after medical management of the suspected missed abortion were analyzed using next-generation sequencing with the report “46,XX complete molar pregnancy”. CONCLUSION(S): To our knowledge, this is the first account of a complete molar pregnancy resulting from the transfer of a reported euploid embryo, highlighting the importance of understanding the limitations of genetic testing platforms in the setting of abnormally fertilized oocyte-derived embryos.