title: Recurrent familial hydatidiform mole - a rare clinical problem.
abstract: Familial recurrent hydatidiform mole is a rare event; here we report an unusual case of a gravida 5 aged 29 years, with five recurrent hydatidiform moles and no normal pregnancy. After the fourth molar pregnancy, she developed persistent trophoblastic disease that required 7 cycles of single agent chemotherapy. Two years after the treatment, she presented with her fifth molar pregnancy. Her elder sister had seven hydatidiform moles from two different unrelated male partners. As this is familial, and recurrent, with no viable conceptions in both the sisters, it is likely to be biparental in origin. Unlike androgenetic moles, biparental moles arise due to a global inherited failure of maternal imprinting. It is an autosomal recessive defect in the female germ line. Genetic analysis is essential, although it is not available in all centers. Donor Oocyte IVF is the only option for women with biparental moles to have normal offspring.
authors.affiliation: Department of Gynaecology and Obstetrics, Kasturba Medical College, Manipal University, Manipal, India.
authors.forename: Lavanya
authors.initials: L
authors.lastname: Rai
authors.affiliation: Department of Gynaecology and Obstetrics, Kasturba Medical College, Manipal University, Manipal, India.
authors.forename: Hebbar
authors.initials: H
authors.lastname: Shripad
authors.affiliation: Department of Gynaecology and Obstetrics, Kasturba Medical College, Manipal University, Manipal, India.
authors.forename: Shyamala
authors.initials: S
authors.lastname: Guruvayare
authors.affiliation: Department of Gynaecology and Obstetrics, Kasturba Medical College, Manipal University, Manipal, India.
authors.forename: Adiga
authors.initials: A
authors.lastname: Prashant
authors.affiliation: Department of Gynaecology and Obstetrics, Kasturba Medical College, Manipal University, Manipal, India.
authors.forename: Anjali
authors.initials: A
authors.lastname: Sunil
keywords: Recurrent hydatidiform mole; donor oocyte invitro fertilisation; familial mole; persistent trophoblastic disease; preimplantation genetic diagnosis