151. Pregnancy after oocyte donation in a patient with NLRP7 gene mutations and recurrent molar hydatidiform pregnancies.
- Author
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Cozette C, Scheffler F, Lombart M, Massardier J, Bolze PA, Hajri T, Golfier F, Touitou I, Rittore C, Gondry J, Merviel P, Benkhalifa M, and Cabry R
- Subjects
- Abortion, Spontaneous genetics, Abortion, Spontaneous physiopathology, Adult, Female, Humans, Hydatidiform Mole pathology, Mutation genetics, Neoplasm Recurrence, Local pathology, Neoplasms genetics, Neoplasms pathology, Oocyte Donation methods, Pregnancy, Pregnancy Complications, Neoplastic pathology, Adaptor Proteins, Signal Transducing genetics, Hydatidiform Mole genetics, Neoplasm Recurrence, Local genetics, Pregnancy Complications, Neoplastic genetics
- Abstract
Molar pregnancies are benign trophoblastic diseases associated with a risk of malignant transformation. If aetiology remains mostly unknown, the risk of recurrent molar pregnancy is around 1.5% after one molar pregnancy and around 25% after 2 molar pregnancies. In the later situation, genetic mutations have been described, increasing hugely this risk. In case of mutations, probability to obtain a normal pregnancy is estimated around 1.8%. We report the case of a Caucasian 30-year-old woman whose previous five spontaneous pregnancies had a negative outcome: a spontaneous miscarriage and then 4 complete hydatidiform moles. Genetic testing revealed that the patient carried two heterozygous mutations in the NLRP7 gene (c.2982-2A > G and Y318CfsX7). According to this, counselling was conducted to advocate for oocyte donation in order to obtain a normal pregnancy. This technique enabled a complication-free, singleton pregnancy that resulted in a healthy term live birth of a 2900 g female. Few months after delivery, the patient presented a new complete hydatidiform mole. Women presented with mutations in the NLRP7, KHDC3L or PADI6 genes are unlikely to obtain normal pregnancies, with a major risk of reproductive failure. In such a context, oocyte donation may be the best option. Only 4 normal pregnancies and deliveries have been published in this situation through this technique to our knowledge.
- Published
- 2020
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