To understand if alternative methods of pregnancies can prevent fetal and neonatal alloimmune thrombocytopenia (FNAIT), it is first important to understand the basic mechanism driving this disease.
In FNAIT, a pregnant woman develops antibodies that attack the platelets of the fetus. Platelets are cells that are needed for blood to clot to stop bleeding. In severe cases, bleeding in the brain can occur, leading to long-lasting consequences.
Can I use IVF to prevent FNAIT?
FNAIT occurs due to a mismatch between maternal and fetal platelet antigens, which are inherited from the father. In vitro fertilization (IVF) involves the implantation of fertilized embryos into a woman’s uterus. This procedure is typically used in cases of which couples find it difficult to conceive. It is also a typically long and expensive process.
IVF can theoretically work to prevent FNAIT if only selected embryos are chosen to be implanted. In the case of FNAIT, this means selecting embryos that have compatibility with the mother’s platelet antigens. The goal here is to select embryos that doctors know in advance would not trigger a FNAIT response during pregnancy.
However, using IVF to prevent FNAIT is not standard practice, and there are very few studies conducted on the subject. This is because current management practices are largely sufficient in preventing severe FNAIT complications, especially when detected early in the pregnancy.
What about egg donations?
If IVF targets the fetal aspect of FNAIT, egg donation targets the maternal aspect. Egg donation may prevent FNAIT under specific scenarios, which essentially requires that there is compatibility between the surrogate’s platelet antigens and that of the fetus. If this can be achieved, then FNAIT will not occur during pregnancy.
However, like IVF, while egg donation can theoretically prevent FNAIT, it is not commonly used for this purpose. Furthermore, like IVF, the process can be long and expensive.
Read more about FNAIT testing and diagnosis
Individuals who are most interested in alternative means to eliminate the risk of FNAIT are typically people who have lost a pregnancy due to FNAIT or suffered from severe complications due to the disease in a previous pregnancy.
If you or your partner are uneasy about a potential future pregnancy due to these factors, consider speaking to your OB-GYN, who may be able to guide you through some of the more common preventative measures that can be taken for future pregnancies. Your doctor will also be able to let you know the options currently available where you live and the estimated costs of such options.
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