Preimplantation genetic testing and prenatal diagnosis in a family with pseudovaginal perineoscrotal hypospadias: A case report

Medicine (Baltimore). 2023 Nov 17;102(46):e36171. doi: 10.1097/MD.0000000000036171.

Abstract

Rationale: Pseudovaginal perineoscrotal hypospadias (PPSH) is a rare autosomal recessive disorder of sex development caused by biallelic mutations in SRD5A2. PPSH is characterized by a vaginal-like blind ending perineal opening, penoscrotal hypospadias, and impaired masculinization.

Patient concerns: We reported preimplantation genetic testing and prenatal diagnosis in a family with PPSH.

Diagnosis: Whole-exome sequencing of the family identified 2 SRD5A2 pathogenic variants (c.578A>G and c.607G>A). Haplotype analysis showed that the variants were inherited from the previous generation of this family.

Interventions: During subsequent in vitro fertilization, preimplantation genetic testing was performed on 9 embryos. One unaffected embryo was transferred, resulting in a singleton pregnancy.

Outcomes: The prenatal diagnosis at 20 weeks' gestation confirmed the fetus was unaffected. A healthy female infant weighing 3100 g and measuring 50 cm was delivered vaginally at 39+5 weeks of gestation.

Lessons subsections: This case highlights the use of preimplantation genetic testing and prenatal diagnosis to prevent the transmission of PPSH in families at risk. Our approach provides an effective strategy for identification and management of families with autosomal recessive disorders like PPSH.

Publication types

  • Case Reports

MeSH terms

  • 3-Oxo-5-alpha-Steroid 4-Dehydrogenase / deficiency
  • Disorder of Sex Development, 46,XY
  • Disorders of Sex Development* / diagnosis
  • Disorders of Sex Development* / genetics
  • Female
  • Genetic Testing
  • Humans
  • Hypospadias* / diagnosis
  • Hypospadias* / genetics
  • Infant
  • Male
  • Membrane Proteins / genetics
  • Pregnancy
  • Preimplantation Diagnosis*
  • Prenatal Diagnosis
  • Steroid Metabolism, Inborn Errors

Substances

  • SRD5A2 protein, human
  • Membrane Proteins
  • 3-Oxo-5-alpha-Steroid 4-Dehydrogenase

Supplementary concepts

  • Pseudovaginal Perineoscrotal Hypospadias