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Stem cell-based model of human monochorionic twin embryo

How human embryos can develop into identical twins - who share the same DNA - is largely unknown. We know that identical twins come from a single fertilized egg that splits into two and it is believed that the timing of this division affects whether the twins will share a placenta and/or an amniotic sac. However, what exactly happens and when was not clear due to the rare incidence of monozygotic twins (around 0.4% of pregnancies) and the impossibility to study this in the uterus. We have now succeeded in forming embryo-like structures of human identical twins purely from stem cells. This advancement makes it possible, for the first time, to glimpse into the processes of how identical twins form. Key to this process is the rapid expansion and subsequent division of the blastocyst, a structure comprising future placental cells that encapsulates the stem cells destined to develop into the embryo.: accelerated expansion of the blastocyst—the sac of future placenta cells that encases the stem cells from which new life can emerge — splits the embryo into two. This discovery has been published in Advanced Materials (Dorian Luijkx et al. https://doi.org/10.1002/adma.202313306 )

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Increased medical risks in twin pregnancies

Assisted reproduction technologies like IVF can increase the chances of having identical twins, possibly due to interventions such as ovarian stimulation, embryo hatching assistance, or embryo freezing. These interventions come at a crucial developmental stage, potentially increasing the chances of these identical twins sharing a placenta around (around 75% of identical twins share a single placenta, named monochorionic twins). Twin pregnancies pose higher risks than single ones, affecting twins and mothers due to complications like uneven blood flow. Yet, practical challenges— only 1 out of 250 embryos spontaneously becomes a twin—essentially limit research into twin development and their potential complications.

The stem cell-based models that we developed for monochorionic twin embryo can mimic the process leading to identical monochorionic twins. This finally allows us to study how identical twins form, and potentially identify why complications arise in twin pregnancies and new routes for prevention or treatment.

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