Fertility Preservation in Girls with Turner Syndrome: Prognostic Signs of the Presence of Ovarian Follicles

Borgström, Birgit; Julius, Hreinsson; Rasmussen, Carsten; Sheikhi, Maryam; Gabriel, Franck; Keros, Victoria; Fridström, Margareta; Hovatta, Outi

doi:10.1210/jc.2008-0708

Cited by 185 publications

(80 citation statements)

References 30 publications

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“…Borgstrom et al examined predictors for the presence of follicles and concluded that follicles were more likely to be found in girls with a mosaic karyotype, a low FSH level, a high antimüllerian hormone level, spontaneous onset of puberty, and spontaneous menarche 19 . Consistent with these reports, the 2 of 3 Turner cases in our study showed AMH levels within normal levels (>1.1 ng/mL), but diminished for their age.…”

Section: Discussionmentioning

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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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: Discussionmentioning

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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“…22,23 Anywhere from 1/4 to 2/3 of ovarian tissue is removed for cryopreservation purposes leaving a partially intact ovary in situ. 17,18,20,22,24,25 In many cases, the right ovary was selected due to its preferred anatomic location away from the sigmoid colon. 26 Dissection was carried out with the use of sharp scissors out of fear for follicle damage secondary to electrocautery burn.…”

Section: Resultsmentioning

confidence: 99%

“…18,20,22,24 One incident of clinically significant intraoperative blood loss requiring transfusion was described in a pediatric patient. 23 …”

Section: Resultsmentioning

confidence: 99%

“…All ovarian cortical tissue was harvested laparoscopically but the amount of tissue removed varied between authors. Borgstrom et al and Feign et al report removing 25-50% of ovarian cortical tissue from one ovary, 19,24 while Lima et al and Fabbri et al report bilateral partial oophorectomies 19,20,23,24 . One patient was reported to have significant intraoperative hemorrhage requiring transfusion, otherwise no significant complications were documented.…”

Section: Resultsmentioning

confidence: 99%

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A review of reported surgical techniques in fertility preservation for prepubertal and adolescent females facing a fertility threatening diagnosis or treatment

Corkum

Laronda

Rowell

2017

The American Journal of Surgery

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Background Ovarian tissue cryopreservation is increasing as a preferred option for fertility preservation for prepubertal and young adolescent females facing a fertility threatening diagnosis or treatment. Data Sources Ovid MEDLINE and PubMed searches for terms related to ovarian tissue removal for fertility preservation revealed there is no current consensus on operative technique for surgical ovarian cortical tissue removal in adult females. Additionally, there are limited published reports of surgical approach and outcomes in the pediatric population. In total, 22 publications were reviewed for their operative approach, ovarian tissue harvesting techniques, complications and outcomes. Conclusions Reported operative approaches and techniques for ovarian tissue cryopreservation for pediatric and adolescent patients are variable. Further investigations into operative technique and tissue harvesting that maintains healthy ovarian follicles for transplant will help establish standard technical principles for surgery in pediatric and adolescent females undergoing fertility preservation.

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“…Predictors for successful autologous IVF include a mosaic peripheral blood karyotype, normal serum FSH and AMH levels, and spontaneous puberty. Negative predictors for successful autologous IVF are monosomy or a structurally anomalous X chromosome, elevated FSH levels, low AMH levels, and lack of spontaneous puberty (22), (15), (26). …”

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 in Girls with Turner Syndrome: Prognostic Signs of the Presence of Ovarian Follicles

Abstract: Signs of spontaneous puberty, mosaicism, and normal hormone concentrations were positive and statistically significant but not exclusive prognostic factors as regards finding follicles.

Cited by 185 publications

References 30 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

A review of reported surgical techniques in fertility preservation for prepubertal and adolescent females facing a fertility threatening diagnosis or treatment

Reproductive Issues in Women with Turner Syndrome

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