TurnerFertility trial: fertility preservation in young girls with Turner syndrome by freezing ovarian cortex tissue—a prospective intervention study

Navigating fertility dilemmas across the lifespan in girls with Turner syndrome—a scoping review

“…After birth, the follicle density was also significantly lower in ovaries of prepubertal girls with TS (131–2121 follicles/mm 3 ) and peri- and post-pubertal girls with TS (50–872 follicles/mm 3 ) compared to age-matched controls (respectively, 2946–7401 and 1553–2045 follicles/mm 3 ) ( Peek et al , 2023 ). Other studies confirmed the reduced follicle density in the ovarian cortex of women with TS ( Borgström et al , 2009 ; Peek et al , 2019 , 2023 ; Schleedoorn et al , 2022 ; Nadesapillai et al , 2023b ). In contrast, Mamsen et al (2019) observed that 7/9 girls with TS with follicles in the ovarian cortex had a follicle density within 95% CI of age-matched controls, although the CI was broad and not specified.…”

“…Abnormal morphology affected 31% of follicles of girls with TS, which was significantly higher compared to individuals without TS with 12% abnormal follicles ( Peek et al , 2023 ). The abnormal morphology of follicles included an incomplete or distorted layer of granulosa cells ( Mamsen et al , 2019 ; Nadesapillai et al , 2023b ), partially missing connection to the basal lamina ( Mamsen et al , 2019 ), a less clear structure of follicles, and darker and smaller oocytes ( Lundgaard Riis et al , 2021 ). Abnormal morphology of follicles was observed more frequently in girls with a structural aberration of the X-chromosome compared to girls with TS without a structural aberration ( Schleedoorn et al , 2022 ; Nadesapillai et al , 2023b ).…”

“…Over the past decades, there has been an increasing request from parents of girls with TS to discuss fertility and fertility preservation options. Accordingly, this led to a growing research interest in fertility preservation in TS, including oocyte vitrification and ovarian tissue cryopreservation (OTC), and the emergence of new data ( Brouillet et al , 2023 ; Nadesapillai et al , 2023b ). However, there are still research gaps that remain, since it is extremely difficult to predict which girls will be diagnosed with premature ovarian insufficiency (POI) at a very young age, and which girls will conceive naturally in the future.…”

Reproductive Outcomes of Women with Turner Syndrome Undergoing Oocyte Vitrification: A Retrospective Multicenter Cohort Study

“…The combination of parameters could be useful for clinicians during fertility counseling in women with TS. In addition, it is preferable to karyotype at least two peripheral cell lines to rule out whether a hidden mosaicism is present [28]. It is important to keep in mind that those without a 46,XX cell line could still be fertile enough to undergo ovarian stimulation successfully or become pregnant spontaneously as a wide variation is seen between karyotype in peripheral cells and ovarian cells [21,29].…”

“…Oocyte vitrification should preferably be performed when the girl is mature enough to understand the procedure, can make adequate decisions, and spontaneous menarche has occurred. OTC should only be offered in a research setting and with caution to those with a sufficient ovarian reserve, preferably prepubertal girls, until more is known about the long-term consequences of OTC in girls with TS and live births have been reported [21,28]. The psychological wellbeing of young girls deserves special attention and responsibility from healthcare providers during counseling and fertility preservation treatment.…”