Fertility preservation by ovarian stimulation and oocyte cryopreservation in a 14-year-old adolescent with Turner syndrome mosaicism and impending premature ovarian failure

Oktay, Kutluk; Rodriguez‐Wallberg, Kenny A.; Şahin, Gülnaz

doi:10.1016/j.fertnstert.2010.01.044

Cited by 82 publications

(61 citation statements)

References 25 publications

(28 reference statements)

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“…Case-2 (previously reported 5 ) was diagnosed with mosaic Turner’s syndrome at the age of 13, subsequent to endocrine evaluation because of repeated fractures due to low impact trauma. Her karyotype was found to be 46,XX (11/20) / 45,X (9/20).…”

Section: Methodsmentioning

confidence: 99%

“…Traditionally, ovarian cryopreservation, the most experimental fertility preservation technique, has been the method of choice in prepubertal and post-pubertal young girls because no ovarian stimulation is needed. Given that oocyte cryopreservation is no longer considered experimental, and given that it is currently uncertain how successful ovarian transplantation will be especially in girls with Turner’s, oocyte cryopreservation may be the preferred method of fertility preservation in post-pubertal young girls 3–5 .…”

Section: Introductionmentioning

confidence: 99%

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Oocyte Cryopreservation for Fertility Preservation in Postpubertal Female Children at Risk for Premature Ovarian Failure Due to Accelerated Follicle Loss in Turner Syndrome or Cancer Treatments

Oktay¹,

Bedoschi²

2014

Journal of Pediatric and Adolescent Gynecology

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Objective To preliminarily study the feasibility of oocyte cryopreservation in post-pubertal girls aged between 13 and 15 years who were at risk for premature ovarian failure due to the accelerated follicle loss associated with Turner’s Syndrome or cancer treatments. Design Retrospective cohort and review of literature. Setting Academic fertility preservation unit. Participants Three girls diagnosed with Turner syndrome, one girl diagnosed with germ-cell tumor and one girl diagnosed with lymphoblastic leukemia. Interventions Assessment of ovarian reserve, ovarian stimulation, oocyte retrieval, in vitro maturation, and mature oocyte cryopreservation. Main Outcome Measure Response to ovarian stimulation, number of mature oocytes cryopreserved and complications, if any. Results Mean AMH, baseline FSH, Estradiol and antral follicle counts were 1.30 ± 0.39, 6.08 ± 2.63, 41.39 ± 24.68, 8.0 ± 3.2; respectively. In Turner girls the ovarian reserve assessment indicated already diminished ovarian reserve. Ovarian stimulation and oocyte cryopreservation was successfully performed in all female children referred for fertility preservation. A range of 4–11 mature oocytes (mean 8.1 ± 3.4) was cryopreserved without any complications. All girls tolerated the procedure well. Conclusions Oocyte cryopreservation is a feasible technique in selected female children at risk for premature ovarian failure. Further studies would be beneficial to test the success of oocyte cryopreservation in young girls.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Oocyte Cryopreservation for Fertility Preservation in Postpubertal Female Children at Risk for Premature Ovarian Failure Due to Accelerated Follicle Loss in Turner Syndrome or Cancer Treatments

Oktay¹,

Bedoschi²

2014

Journal of Pediatric and Adolescent Gynecology

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“…Oktay et al have reported on successful oocyte cryopreservation in post-pubertal children with mosaic TS 25,26 . In these reports, three girls aged 13–15 with mosaic TS were identified to have decreased ovarian reserve by serum AMH hormone measurements and antral follicle counts on ultrasound examinations.…”

Section: Fertility Preservation Strategiesmentioning

confidence: 99%

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

Oktay

Bedoschi

Berkowitz

et al. 2016

Journal of Pediatric and Adolescent Gynecology

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156

129

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This article reviews the existing fertility preservation options for females diagnosed with Turner syndrome and provides practical guidelines for the practitioner. Turner syndrome is the most common sex chromosome abnormality in females, occurring in approximately one in 2500 live births. Women with Turner syndrome are at extremely high risk for primary ovarian insufficiency (POI) and infertility. Although about 70–80% have no spontaneous pubertal development and 90% experience primary amenorrhea, the remainder may 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, so as 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 as the vast majority will have their ovarian reserve depleted before adulthood. Cryopreservation of mature oocytes and embryos is a proven fertility preservation approach, while cryopreservation of ovarian tissue is a promising technique with a growing number of live births, but remain investigational. Oocyte cryopreservation has been performed in children with Turner syndrome as young as 13 and ovarian tissue cryopreservation in prepubertal children affected. 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 desire for parenting. For those with Turner syndrome related cardiac contraindications to pregnancy, utilization of gestational surrogacy allows the possibility of biological parenting by using their own oocytes. Alternatively, gestational surrogacy can serve to carry pregnancy resulting from the use of donor oocytes or embryos, if needed.

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“…It may be better to obtain oocytes for cryopreservation before ovarian failure begins. Additionally, there have been several case reports of adolescents and adults with Turner syndrome undergoing ovarian stimulation followed by both oocyte and ovarian tissue cryopreservation for later IVF (27), (28), (29). However, there is currently no evidence regarding the safety of ovarian stimulation regimens in pre-pubertal females, and it is unknown what effect these treatments may have on overall pubertal development or adult height.…”

Section: Pregnancy In Turner Syndromementioning

confidence: 99%

Reproductive Issues in Women with Turner Syndrome

Folsom

Fuqua

2015

Endocrinology and Metabolism Clinics of North America

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Synopsis Turner syndrome is one of the most common chromosomal abnormalities affecting female infants. The severity of clinical manifestations generally varies and affects multiple organ systems. Women with Turner syndrome have a threefold increase in mortality, which becomes even more pronounced in pregnancy. There are several reproductive options available for women with Turner syndrome, including adoption or surrogacy, assisted reproductive techniques, and in rare cases spontaneous pregnancy. There are well-documented risks for women with Turner syndrome during pregnancy, including specific risks of aortic pathology, hepatic disease, thyroid disease, type 2 diabetes, and Cesarean section delivery. Several professional societies have published guidelines to aid in the care of women with Turner syndrome prior to and during pregnancy. It is important for providers who care for these women to be familiar with the specific risks and recommendations in caring for women with Turner syndrome of reproductive age.

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Fertility preservation by ovarian stimulation and oocyte cryopreservation in a 14-year-old adolescent with Turner syndrome mosaicism and impending premature ovarian failure

Cited by 82 publications

References 25 publications

Oocyte Cryopreservation for Fertility Preservation in Postpubertal Female Children at Risk for Premature Ovarian Failure Due to Accelerated Follicle Loss in Turner Syndrome or Cancer Treatments

Oocyte Cryopreservation for Fertility Preservation in Postpubertal Female Children at Risk for Premature Ovarian Failure Due to Accelerated Follicle Loss in Turner Syndrome or Cancer Treatments

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

Reproductive Issues in Women with Turner Syndrome

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