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Hum. Reprod. Advance Access published online on January 20, 2005
Human Reproduction, doi:10.1093/humrep/deh624
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Human Reproduction © European Society of Human Reproduction and Embryology 2005; all rights reserved
Received July 29, 2004
Accepted October 29, 2004

Case Report

The role of preimplantation genetic diagnosis in the management of severe rhesus alloimmunization: first unaffected pregnancy:Case report

S.K.M. Seeho 1*, G. Burton 2, D. Leigh 3, J.T. Marshall 3, J.W. Persson 4, and J.M. Morris 1

1 Department of Obstetrics, University of Sydney, Royal North Shore Hospital, Sydney, Australia
2 Department of Obstetrics, Royal North Shore Hospital, Sydney, Australia 2065
3 Sydney IVF, Sydney, Australia 2000
4 IVF Australia, Sydney, Australia 2000

* To whom correspondence should be addressed.
S.K.M. Seeho, E-mail: seanseeho{at}med.usyd.edu.au


  Abstract

Rhesus (Rh) D alloimmunization may cause haemolytic disease of the fetus and newborn if the fetal Rh blood type is positive. Although the incidence of severe RhD alloimmunization has decreased with prophylactic anti-D immunoglobulin administration during and after pregnancy, sensitization still occurs in a small group of women. In such women, Rh disease will continue to be significant problem and for their babies who may be affected. Preimplantation genetic diagnosis (PGD) may be utilized to avoid materno-fetal blood group incompatibility in an RhD-sensitized woman. Biopsy of a single cell from early cleavage-stage embryos screening for RhD-negative embryos allows the transfer of only RhD-negative embryo(s) into the uterus. This avoids any complications related to haemolytic disease of the fetus and newborn. This article describes the first reported case of an unaffected pregnancy using PGD for Rh disease. IVF and embryo transfer resulted in a clinical pregnancy and the birth of a healthy girl confirmed to be blood type RhD negative. PGD in couples with a heterozygous RhD-positive male partner provides an option for avoiding haemolytic disease of the newborn in RhD alloimmunized mothers.

Keywords: blastomere biopsy; haemolytic disease of the newborn; PCR; preimplantation genetic diagnosis; rhesus alloimmunization.
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