Fertility issues and pregnancy outcomes in Turner syndrome

Abstract

OD) outcomes. Conditions associated with aortic dissection and poor pregnancy outcomes at preconception were considered. Pregnancy-related aortic dimension changes and the long-term impact of pregnancy on TS-related comorbidities were assessed. Results(s): In all, 13.5% had spontaneous pregnancies, resulting in a pregnancy with live birth in 18 patients (37 newborns); 16% considered OD, one adopted, and one underwent fertility preservation.Spontaneous pregnancy predictive factors were a karyotype with a second or third cell line with more than one X and spontaneous menarche. In all, 47.6% had miscarriages, two experienced preeclampsia, and two had gestational diabetes. One daughter was diagnosed with TS in adulthood.Seven of 14 who attempted OD had a pregnancy with live birth; two of seven had gestational diabetes; 64.3% attempting OD had risk factors associated with poor pregnancy outcomes, including four who had double embryo transfer. Cardiac status at preconception was evaluated in 12 of 25 women who had a pregnancy. The aortic diameters during pregnancy increased. The aortic growth at sinuses was 0.51 AE 0.71 mm/year and at ascending aorta 0.67 AE 0.67 mm/year, reaching a significant difference at sinuses compared with the growth in nulliparous TS. Among women who had a pregnancy, none experienced aortic dissection during and in the years after pregnancy. Conclusion(s):This study highlights the importance of a TS-dedicated multidisciplinary management of pregnancy, before and during pregnancy and in the postpartum period. (Fertil Steril Ò 2020;114:144-54. Ó2020 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

Subsequent menstrual disorder after spontaneous menarche in Turner syndrome

“…TS patients exhibit more foetal and maternal complications than women without TS, including miscarriage, foetal anomaly, and maternal morbidity and mortality. This should be considered at the time of fertility preservation 23 …”

“…This should be considered at the time of fertility preservation. 23 Furthermore, we evaluated subsequent menstruation disorders according to karyotype (Table 3, Figures 2 and S2). The results of karyotype testing were consistent with those of previous reports reporting that patients with mosaicism more often have spontaneous menarche.…”

Cryopreservation of paediatric ovarian tissue with an updated version of the Edinburgh criteria for appropriate patient selection

“…In the mosaic type (45,X/46,XX, 45,X/47,XXX, 45,X/46,XX/47,XXX), the possibility of spontaneous pregnancy remains, albeit at a low rate. However, it should also be recognized that the miscarriage rate is high (Calanchini et al 2020).…”

Pregnancies in women with Turner syndrome: a retrospective multicentre UK study

“…Only about a third of women with TS will have signs of spontaneous puberty, and the majority of women with TS experience premature ovarian failure at a young age 8 . This limits the possibility of spontaneous pregnancy 9–12 . As assisted reproductive technologies have become increasingly available, over the last 10 years there have been a number of cohort studies reporting pregnancies through oocyte donation in women with TS 12–15 .…”

“…This limits the possibility of spontaneous pregnancy 9–12 . As assisted reproductive technologies have become increasingly available, over the last 10 years there have been a number of cohort studies reporting pregnancies through oocyte donation in women with TS 12–15 . However, concerns have been expressed regarding the high rate of maternal complications in women with TS 10–13 …”