Pregnancies and obstetrical prognosis after oocyte donation in Turner Syndrome: A multicentric study

Andre, Hélène; Pimentel, Céline; Veau, Ségolène; Domin‐Bernhard, Mathilde; Letur-Könirsch, H.; Priou, G; Eustache, Florence; Vorilhon, Solène; Delépine-Panisset, Béatrice; Fauque, Patricia; Scheffler, Florence; Benhaïm, Annie; Blagosklonov, Oxana; Koscinski, Isabelle; Ravel, Célia

doi:10.1016/j.ejogrb.2019.05.012

Cited by 18 publications

(19 citation statements)

References 36 publications

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“…Similarly, a Canadian study also showed greater rates of preterm birth and small for gestational age in this cohort of women 23 . Andre et al 13 . reported rates of gestational hypertension of 28% and pre‐eclampsia of 10.3% in 39 pregnancies, with gestational diabetes in 7.7%.…”

Section: Discussionsupporting

confidence: 56%

“…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 …”

Section: Introductionmentioning

confidence: 99%

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

Cauldwell

Steer

Adamson

et al. 2022

BJOG

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Objective To determine the characteristics and outcomes of pregnancy in women with Turner syndrome. Design Retrospective 20‐year cohort study (2000–20). Setting Sixteen tertiary referral maternity units in the UK. Population or sample A total of 81 women with Turner syndrome who became pregnant. Methods Retrospective chart analysis. Main outcome measures Mode of conception, pregnancy outcomes. Results We obtained data on 127 pregnancies in 81 women with a Turner phenotype. All non‐spontaneous pregnancies (54/127; 42.5%) were by egg donation. Only 9/31 (29%) pregnancies in women with karyotype 45,X were spontaneous, compared with 53/66 (80.3%) pregnancies in women with mosaic karyotype 45,X/46,XX (P < 0.0001). Women with mosaic karyotype 45,X/46,XX were younger at first pregnancy by 5.5–8.5 years compared with other Turner syndrome karyotype groups (P < 0.001), and more likely to have a spontaneous menarche (75.8% versus 50% or less, P = 0.008). There were 17 miscarriages, three terminations of pregnancy, two stillbirths and 105 live births. Two women had aortic dissection (2.5%); both were 45,X karyotype with bicuspid aortic valves and ovum donation pregnancies, one died. Another woman had an aortic root replacement within 6 months of delivery. Ten of 106 (9.4%) births with gestational age data were preterm and 22/96 (22.9%) singleton infants with birthweight/gestational age data weighed less than the tenth centile. The caesarean section rate was 72/107 (67.3%). In only 73/127 (57.4%) pregnancies was there documentation of cardiovascular imaging within the 24 months before conceiving. Conclusions Pregnancy in women with Turner syndrome is associated with major maternal cardiovascular risks; these women deserve thorough cardiovascular assessment and counselling before assisted or spontaneous pregnancy managed by a specialist team. Tweetable abstract Pregnancy in women with Turner syndrome is associated with an increased risk of aortic dissection.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

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

Cauldwell

Steer

Adamson

et al. 2022

BJOG

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“…However, aortic dissection may also occur in the absence of known risk factors and at an aortic diameter of < 4 cm [21]. Other possible complications of pregnancy include thyroid dysfunction, obesity, diabetes, hydronephrosis, hypertension, and preeclampsia [3,6,23,24]. Overall, maternal mortality in TS women has been reported to be as high as 1-2%, which is 100-200 times greater than in the general population [3,6,25].…”

Section: Chromosomal Abnormalities (Turner Syndrome)mentioning

confidence: 99%

Fertility preservation for genetic diseases leading to premature ovarian insufficiency (POI)

Marca

Mastellari

2021

J Assist Reprod Genet

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Purpose The current review aims to summarize the data available concerning the applicability of fertility preservation techniques to genetic conditions at risk of premature ovarian insufficiency (POI). Methods A literature review through the PubMed Database was carried out. Results About 10% of cases of POI is related to genetic diseases. The most frequent conditions associated with POI are Turner syndrome and fragile X pre-mutation; mutation of BRCA 1-2 genes and several other mutations and genetic syndromes have recently been highlighted, although they rarely occur. If a diagnosis is issued before POI onset, counseling on currently available fertility preservation techniques is advisable. In case of spontaneous menarche (this can occur variably depending on the mutation) established techniques like embryo or oocyte cryopreservation can be proposed, even if, in some cases, their effectiveness may be reduced by ovarian alterations connected to the mutation. Ovarian tissue cryopreservation has recently been defined as an established medical procedure for fertility preservation in young cancer patients and may be an option for prepubertal patients. However, it is still experimental in special populations with genetic diseases causing POI. New innovative experimental techniques, like in vitro maturation of immature oocytes (IVM) and vitro activation (IVA) of immature follicles on ovarian tissue, have shown limited but encouraging data and they will be probably available in the near future. For a correct riskbenefit evaluation, the following aspects should be considered: actual knowledge about the pathology-specific efficacy of the various techniques, the average age of onset of POI, the possible risks associated with the procedure in relation to the underlying pathology, the probability of spontaneous conception, as well as the health implications of a possible future pregnancy.. Conclusions Fertility preservation techniques represent a crucial opportunity for patients with genetic risk of POI. Early diagnosis increases the chances to apply these techniques. No specific recommendations concerning fertility preservation for each genetic pathology are available, and clinicians should first counsel the patient and her relatives about known risks and benefits of the available techniques, both those established and those considered as experimental.

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“…Most women with TS have reportedly used donor oocytes for in vitro fertilization (IVF-DO) and successful pregnancy, with a success rate of ∼37.8% (46). Andre et al (47) reported that from 2012 to 2016, 73 women with TS obtained oocytes from 10 oocytes donation centers in France, resulting in 39 successful pregnancies after embryo transfer. However, IVF-DO has not been implemented in many countries due to ethical disputes and legal issues.…”

Section: Oocyte Donation and Embryo Cryopreservationmentioning

confidence: 99%

“…For women with TS, there are more maternal and fetal complications irrespective of the method of conception. In 2019, Andre et al (47) reported 151 cases of embryo transfer and 39 cases of gestation in 73 TS patients, including 24 cases of healthy delivery, 11 cases of spontaneous abortion, 3 cases of artificial abortion, 1 case of ectopic pregnancy, 1 case of noncardiovascular death due to gestational hypertension. Moreover, the risk of spontaneous abortion is higher, mainly due to genetic abnormalities of the fetus.…”

Section: Pregnancy In Turner Syndrome and Complications Of Pregnancymentioning

confidence: 99%

Progress in Fertility Preservation Strategies in Turner Syndrome

Yeh

Kosteria

et al. 2020

Front. Med.

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Growth retardation and gonadal dysgenesis are two of the most important clinical manifestations of Turner syndrome (TS). As premature ovarian failure generally occurs early in life in women with TS, these patients should be counseled and evaluated as early as possible for discussion of optimal and individualized fertility preservation strategies. Infertility seriously affects the quality of life of women with TS. For those who have ovarian reserve, the theoretical options for future fertility in TS patients include cryopreservation of oocytes, ovarian tissues, and embryos. For those who have already lost their ovarian reserve, oocyte or embryo donation, gestational surrogacy, and adoption are strategies that allow fulfillment of desire for parenting. This review describes the etiologies of infertility and reviews the fertility preservation strategies for women with TS.

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Pregnancies and obstetrical prognosis after oocyte donation in Turner Syndrome: A multicentric study

Cited by 18 publications

References 36 publications

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

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

Fertility preservation for genetic diseases leading to premature ovarian insufficiency (POI)

Progress in Fertility Preservation Strategies in Turner Syndrome

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