Sextuplet Gestation Following an In Vitro Fertilization Pregnancy in a Surrogate Mother: A Case Report

Background: Sextuplet gestation is a high-order multiple pregnancy that is extremely rare and carries significant risks for both the mother and the fetuses. The aim of this report was to document a case of sextuplet gestation following an in vitro fertilization (IVF) pregnancy in a surrogate mother. Case Presentation: She is a 26-year-old P 3 + 0 who presented to St Elizabeth Hospital and Fertility Centre Limited for the purpose of surrogacy. She is a twin and both parents are twins. She subsequently started the in-vitro fertilization procedure and 3 embryos were transferred. Pregnancy was confirmed 2 weeks post-transfer. However, an ultrasound scan done 7 weeks after transfer showed 6 fetuses with cardiac activity. Pregnancy was uneventful until 25 weeks of gestation, when she started having preterm contractions and was placed on permanent hospital admission. She was given antenatal steroids at 28 weeks of gestation. She had an emergency caesarean section at 29 weeks + 2 days gestation following placental abruption and had 4 female neonates and 2 male neonates. Conclusion: Sextuplet gestations are uncommon higher order multiples that are associated with maternal and perinatal morbidity and mortality, as well as preterm contractions, preterm prelabour rupture of membrane and preterm delivery.