Use of a gestational carrier for a patient with recurrent adverse pregnancy outcomes from early onset severe pre-eclampsia.

Objective: To describe the first reported case of gestational carrier treatment to prevent severe early onset pre-eclampsia.

Design: Case report.

Setting: A university-based reproductive endocrinology and infertility clinic and a tertiary care hospital.

Patient(s): A 29-year-old woman and her husband with three consecutive pregnancies complicated by early onset severe pre-eclampsia causing fetal demises at 22 and 24 weeks gestation; a neonatal death at 25 weeks gestation; and life-threatening maternal hemolysis, elevated liver enzymes, and low platelets.

Intervention(s): An IVF procedure in the patient using her husband's sperm with the transfer of two embryos to a friend who offered to be a gestational carrier.

Main Outcome Measure(s): Successful IVF cycle in the patient and uncomplicated pregnancy and delivery in the gestational carrier.

Result(s): The gestational carrier achieved a pregnancy and progressed without complications to delivery of a healthy, 3.2-kg infant at 39 weeks gestation.

Conclusion(s): The use of a gestational carrier deserves consideration as a treatment option in patients with poor reproductive histories because of early onset severe pre-eclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome. This experience also suggests that development of pre-eclampsia may be in large part maternally rather than embryologically or paternally driven.