Illustration of twin pregnancy complication after IVF

Twin Pregnancy After IVF: Understanding the Rare Risk of Molar Pregnancy and GTD

Lena Voss in Health & Wellness December 2025 • 4 min read.

"A new case study sheds light on gestational trophoblastic disease (GTD) following a rare twin pregnancy complication after IVF, offering crucial insights for women and fertility specialists."

Achieving pregnancy through in vitro fertilization (IVF) is a significant milestone for many, but it's essential to be aware of potential complications, even if rare. One such complication is twin pregnancy with complete hydatidiform mole and coexisting fetus (CHMCF), a condition where a molar pregnancy occurs alongside a healthy fetus. While CHMCF is already rare, its occurrence after assisted reproductive technologies (ART) like IVF is even less common, making research and understanding crucial.

A recent case study published in the Taiwanese Journal of Obstetrics & Gynecology details a challenging case of multiple metastatic gestational trophoblastic disease (GTD) following a CHMCF pregnancy achieved through IVF. The study not only presents the clinical course of the patient but also reviews existing literature to highlight the unique features and management considerations for CHMCF after ART.

This article breaks down the key findings of this case report and literature review, offering accessible information about CHMCF, its potential link to ART, the risks involved, and the importance of vigilance during and after pregnancy. Whether you're considering IVF, currently pregnant after ART, or simply interested in women's health, understanding this rare condition can empower you to make informed decisions and advocate for the best possible care.

CHMCF and GTD: Unpacking the Risks

Illustration of twin pregnancy complication after IVF

Complete hydatidiform mole with coexisting fetus (CHMCF) is a rare type of twin pregnancy where one twin develops normally, while the other transforms into a molar pregnancy. A molar pregnancy is a gestational trophoblastic disease (GTD) characterized by abnormal growth of placental tissue. Instead of a healthy placenta, a mass of cysts forms, and in complete moles, there's no fetal development within that molar tissue. CHMCF presents significant risks, including:

While advancements in reproductive technology have made parenthood possible for many, it's crucial to acknowledge potential complications. IVF and other ART procedures might slightly elevate the risk of certain pregnancy complications, including CHMCF. The reasons for this potential link are still being investigated, but some theories involve:

Superovulation: The use of fertility drugs to stimulate the ovaries may play a role.
Oocyte Handling: Procedures during IVF could potentially disrupt the egg's genetic material.
Genetic Factors: The mechanisms disrupting meiotic spindle (chromosome separation) due to oocyte handling, fragmentation of oocytes can lead to CHMCF.

It's important to emphasize that the overall risk remains low, and most IVF pregnancies are healthy and successful. However, understanding the potential association allows for heightened awareness and monitoring.

The Takeaway: Vigilance and Informed Decisions

The case study and literature review highlight the importance of vigilance and careful monitoring during and after pregnancies achieved through ART, particularly in cases of twin pregnancies. While CHMCF remains rare, its potential for serious complications, including GTD, warrants proactive management.

If you're undergoing IVF or other ART procedures, discuss the potential risks and benefits thoroughly with your fertility specialist. Ask about monitoring protocols for early detection of complications like CHMCF, and ensure you understand the signs and symptoms to watch out for. Early detection and intervention are crucial for successful management and treatment of GTD.

Ultimately, informed decision-making, open communication with your healthcare providers, and a proactive approach to monitoring can help ensure a safe and healthy pregnancy journey. Although cases like the one described are concerning, they also drive research and improve our understanding of reproductive health, leading to better care for all.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.tjog.2018.06.020, Alternate LINK

Title: Multiple Metastatic Gestational Trophoblastic Disease After A Twin Pregnancy With Complete Hydatidiform Mole And Coexisting Fetus, Following Assisted Reproductive Technology: Case Report And Literature Review

Subject: Obstetrics and Gynecology

Journal: Taiwanese Journal of Obstetrics and Gynecology

Publisher: Elsevier BV

Authors: Ichiro Nobuhara, Naoya Harada, Noriko Haruta, Yumi Higashiura, Hideki Watanabe, Shioka Watanabe, Hiroyasu Hisanaga, Toshiyuki Sado

Published: 2018-08-01

Everything You Need To Know

What exactly is Complete hydatidiform mole with coexisting fetus (CHMCF)?

Complete hydatidiform mole with coexisting fetus (CHMCF) is a very rare condition that can occur in twin pregnancies, where one twin develops normally, but the other transforms into a molar pregnancy. This means that instead of a healthy placenta and fetus, there is an abnormal growth of placental tissue that forms a mass of cysts, and, in complete moles, no fetus develops within that tissue. This condition is particularly relevant in the context of in vitro fertilization (IVF) because of the potential for increased risk.

What is Gestational trophoblastic disease (GTD) and what is its relationship to CHMCF?

Gestational trophoblastic disease (GTD) is a group of conditions characterized by abnormal growth of cells that would normally develop into the placenta. It can occur after any type of pregnancy, including both natural conceptions and pregnancies achieved through assisted reproductive technologies (ART) such as IVF. GTD, which includes conditions like complete hydatidiform mole, can become metastatic, spreading to other parts of the body and posing significant health risks. The link to CHMCF is important because CHMCF pregnancies can lead to GTD, making early detection and treatment crucial.

Why is CHMCF a significant concern, especially in the context of assisted reproductive technologies (ART) like IVF?

The significance of CHMCF and its connection to IVF lies in the potential for serious complications, particularly the development of GTD. While the overall risk is low, the potential severity of GTD warrants careful monitoring during and after pregnancy, especially in twin pregnancies conceived through IVF. This includes vigilant screening for signs of GTD, such as elevated hormone levels, and prompt intervention if necessary. This highlights the need for heightened awareness and proactive management strategies to ensure the best possible outcomes.

Are there any potential reasons why IVF might be linked to CHMCF?

The potential link between IVF and CHMCF is still under investigation, but some theories suggest potential contributing factors. These include the use of fertility drugs for superovulation, which stimulates the ovaries, and the procedures involved in oocyte handling during IVF. Additionally, genetic factors may play a role. The mechanisms disrupting meiotic spindle (chromosome separation) due to oocyte handling, fragmentation of oocytes can lead to CHMCF. However, it's important to remember that the majority of IVF pregnancies are healthy and successful.

Why is it important to understand the risks associated with CHMCF and GTD if you are considering IVF?

If you are considering or undergoing IVF, understanding the rare risks, like CHMCF and subsequent GTD, is crucial. It empowers you to make informed decisions, discuss concerns with your healthcare provider, and advocate for appropriate monitoring and care. This includes being aware of the symptoms and the importance of follow-up care after the pregnancy. By staying informed, individuals can actively participate in their healthcare journey and help ensure the best possible outcomes for both the mother and the baby.