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Fertility Preservation in Women with Turner Syndrome: A Comprehensive Review and Practical Guidelines.

Abstract：

:In this article we review the existing fertility preservation options for women diagnosed with Turner syndrome and provide practical guidelines for the practitioner. Turner syndrome is the most common sex chromosome abnormality in women, occurring in approximately 1 in 2500 live births. Women with Turner syndrome are at extremely high risk for primary ovarian insufficiency and infertility. Although approximately 70%-80% have no spontaneous pubertal development and 90% experience primary amenorrhea, the remainder might possess a small residual of ovarian follicles at birth or early childhood. The present challenge is to identify these women as early in life as is possible, to allow them to benefit from a variety of existing fertility preservation options. To maximize the benefits of fertility preservation, all women with Turner syndrome should be evaluated by an expert as soon as possible in childhood because the vast majority will have their ovarian reserve depleted before adulthood. Cryopreservation of mature oocytes and embryos is a proven fertility preservation approach, and cryopreservation of ovarian tissue is a promising technique with a growing number of live births, but remains investigational. Oocyte cryopreservation has been performed in children with Turner syndrome as young as 13 years of age and ovarian tissue cryopreservation in affected prepubertal children. However, current efficacy of these approaches is unknown in this cohort. For those who have already lost their ovarian reserve, oocyte or embryo donation and adoption are strategies that allow fulfillment of the desire for parenting. For those with Turner syndrome-related cardiac contraindications to pregnancy, use of gestational surrogacy allows the possibility of biological parenting using their own oocytes. Alternatively, gestational surrogacy can serve to carry pregnancy resulting from the use of donor oocytes or embryos, if needed.

journal_name

J Pediatr Adolesc Gynecol

journal_title

Journal of pediatric and adolescent gynecology

authors

Oktay K,Bedoschi G,Berkowitz K,Bronson R,Kashani B,McGovern P,Pal L,Quinn G,Rubin K

doi

10.1016/j.jpag.2015.10.011

subject

Has Abstract

pub_date

2016-10-01 00:00:00

pages

409-416

issue

eissn

1083-3188

issn

1873-4332

pii

S1083-3188(15)00357-5

journal_volume

pub_type

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Fertility Preservation in Women with Turner Syndrome: A Comprehensive Review and Practical Guidelines.