The case report by Zuppa and coworkers1 in this issue raises some interesting and important questions about assisted reproductive technology (ART). The case presented is a relatively uncomplicated report of the detection and resolution of ABO hemolytic disease of the fetus and newborn (HDFN) in dizygotic twins of a group O mother. The first flag of suspicion was raised by the AB blood group status of both neonates, which prompted a more detailed investigation of the obstetric history of the mother. This history revealed that ART had been performed with donated oocytes, a fact that the mother was reluctant to admit. But what other condition could have caused such a finding and how could it be identified simply in the laboratory?
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