title: Fetal and neonatal alloimmune thrombocytopenia in pregnancies involving in vitro fertilization: a report of four cases.
abstract: OBJECTIVE
  We report four cases of neonatal alloimmune thrombocytopenia (NATP) in pregnancies achieved with in vitro fertilization.
  
  
  METHODS
  Three cases used surrogate carriers, and the fourth a donor egg. Sera from gestational carriers were tested for platelet antibodies by flow cytometry and enzyme-linked immunosorbent assay. Platelet antigen genotyping of biologic mothers, fathers, and surrogates was performed by amplification of DNA by using polymerase chain reaction with sequence-specific primers.
  
  
  RESULTS
  In all 4 cases, NATP resulted from an incompatibility between the fetus and gestational carrier for the platelet-specific alloantigen HPA-1a. Four infants were born severely thrombocytopenic (platelets <50,000/muL), 2 had antenatal intracranial hemorrhage, and 1 fetus expired in utero at 29 weeks.
  
  
  CONCLUSIONS
  NATP can occur in the setting of assisted reproductive technology. Because of the great costs, both financial and emotional, associated with these pregnancies, we strongly recommend that all women be typed for HPA-1a before serving as a surrogate mother.
authors.affiliation: The Blood Center of Southeastern Wisconsin, Milwaukee, Wis, USA. brcurtis@bcsew.edu
authors.forename: Brian R
authors.initials: BR
authors.lastname: Curtis
authors.forename: James B
authors.initials: JB
authors.lastname: Bussel
authors.forename: Marilyn J
authors.initials: MJ
authors.lastname: Manco-Johnson
authors.forename: Richard H
authors.initials: RH
authors.lastname: Aster
authors.forename: Janice G
authors.initials: JG
authors.lastname: McFarland
mesh_terms: D000328:Adult; D016824:Antigens, Human Platelet / Q000276:immunology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007231:Infant, Newborn; D039661:Integrin beta3; D008875:Middle Aged; D011247:Pregnancy; D013921:Thrombocytopenia / Q000209:etiology / Q000276:immunology*
chemical_list: D016824:Antigens, Human Platelet; C061248:ITGB3 protein, human; D007074:Immunoglobulin G; D039661:Integrin beta3