# Hydatidiform Mole and coexisting fetus following intrauterine insemination: a case report

## TL;DR

A rare case of twin pregnancy with one healthy fetus and one molar pregnancy following intrauterine insemination is reported, highlighting potential complications.

## Contribution

This case report presents a rare occurrence of hydatidiform mole coexisting with a normal fetus after IUI.

## Key findings

- A twin pregnancy resulted in one normal fetus and one molar degeneration after IUI.
- The patient developed preeclampsia and required cesarean delivery at 33 weeks.
- MRI is a useful tool for diagnosing and differentiating cystic lesions in such cases.

## Abstract

Gestational trophoblastic diseases (GTD) comprise a heterogeneous group of
disorders arising from genetic anomalies occurring during fertilization in twin
pregnancies and often may be associated with assisted reproductive techniques.
An exceedingly rare presentation of GTD is a twin pregnancy hydatidiform mole
with a co-existing fetus, condition which may be an important cause of
complications for the mother and the fetus. A 36-year-old woman (G2, P0, A1)
underwent a friendly controlled ovarian stimulation (COS) followed by
intrauterine insemination (IUI) for assisted reproductive purposes, resulting in
a twin pregnancy initially characterized by two gestational sacs. However, one
sac failed to progress and instead degenerated into molar trophoblastic disease,
while the other sustained a normal fetus with regular growth. At 33 weeks
gestation, the patient developed preeclampsia, necessitating delivery via
cesarean section at a tertiary care facility. Reproductive-assisted procedures
may be linked to cases of trophoblastic disease. Additionally, the presence of
cystic lesions warrants a wide differential diagnosis, with magnetic resonance
imaging serving as a valuable tool for accurate assessment and differentiation
of structures.