Zygotic Splitting after Assisted Reproduction

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Abstract
It is unknown why monozygotic twins are more frequent in conceptions brought about by assisted-reproduction techniques.1-4 One hypothesis is that the exposure of the zona pellucida to biochemical or mechanical trauma leads to herniation of the blastocyst and cleavage of the zygote. This possibility is not only of biologic importance in understanding spontaneous monozygotic twinning but is a major area of clinical concern, primarily because of the confirmed increase in morbidity and mortality associated with monozygotic twinning.