Reciprocal IVF is an established method for lesbian couples to have a child to whom they both have a biological connection. It involves one partner being the genetic parent by providing the oocytes which following fertilization are then implanted in the other partner’s womb who then acts as the gestational parent. Pregnancy from donated oocytes is a significant risk factor for pre-clampsia. We report a case where both partners in a lesbian couple underwent concurrent reciprocal IVF and a PLGF test diagnosed a high risk of pre-eclampsia in one partner. Partner A aged 39 conceived first. She was at high risk of pre-eclampsia according to NICE guidance so she was prescribed low dose aspirin in early pregnancy. Her blood pressure was normal throughout her pregnancy and she did not develop pre-eclampsia. She delivered via emergency c-section after admission with PPROM at 35 weeks. Partner B aged 38 conceived 15weeks later. She was not deemed high risk for pre-eclampsia according to NICE guidance. At 28+6 weeks she was diagnosed with gestational hypertension without proteinuria. A PLGF test was performed which was <12 mg/ml. At 33+5 weeks she was admitted with a blood pressure of 152/98, significant proteinuria, and diagnosed with pre-eclampsia. She delivered at 34 weeks via emergency c-section due to worsening hypertension and raised pulsatility index in the foetal umbilical artery doppler. Our experience, highlighted by this case report, suggests that patients considering Reciprocal IVF are properly counselled about the significantly increased pre-eclampsia risk and the possible maternal and foetal complications. If Reciprocal IVF or donor oocytes are the chosen assisted reproductive technique, we recommend consideration of low-dose aspirin in early pregnancy. PLGF levels may also allow prompt detection of risk and appropriate antenatal scheduling. We suggest that ‘pregnancy from donated oocytes’ becomes a documented risk factor for pre-eclampsia under NICE guidelines.
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