Pregnancies in women with Turner's syndrome

Abstract

Ovarian failure is a typical feature in Turner's syndrome. Therefore, hormone replacement therapy (HRT) is necessary to achieve the development of normal female sexual characteristics and to prevent cardiovascular complications and osteoporosis. Spontaneous puberty occurs in 5-10% of women with Turner's syndrome, and 2-5% of them become pregnant spontaneously. Sexually active young women with Turner's syndrome need contraception. It can be administered as contraceptive pills, which also serve as HRT. Oocyte donation is now a treatment option for infertility of these women. Excellent results have been obtained with 46% of embryo transfers resulting in pregnancy. The pregnancies carry high risks and have to be followed up carefully. The children born following oocyte donation have no additional risks. Risks can be reduced by transferring only one embryo at a time to the uterus, thus avoiding twin pregnancies. Ovarian tissue from young girls with Turner's syndrome could be cryopreserved for infertility treatment in the future, but the optimal age of ovarian biopsy has to be studied, and methods of replantation and maturation of oocytes in vitro have still to be developed. Fertility counselling has become important in the treatment of girls with Turner's syndrome.

PIP: Ovarian failure and amenorrhea are the typical features in Turner's syndrome resulting from an accelerated loss of oocytes from the ovaries after the 18th week of fetal life or over a few postnatal months or years. The cause and mechanism of this loss are unknown. About 5-10% of girls with Turner's Syndrome have spontaneous pubertal development and 5% having menstrual periods. Therefore, hormone replacement therapy (HRT) is necessary to achieve the development of normal female sexual characteristics and to prevent cardiovascular complications and osteoporosis. Spontaneous puberty occurs in 5-10% of women with Turner's syndrome, and 2-5% of them have become pregnant spontaneously. Sexually active young women with Turner's syndrome need contraception. It can be administered as contraceptive pills, which also serve as HRT. Oocyte donation is now a treatment option for infertility of these women. Excellent results have been obtained with 46% of embryo transfers resulting in pregnancy. The pregnancies carry high risks and have to be followed up carefully. The children born following oocyte donation have no additional risks. Risks can be reduced by transferring only one embryo at a time to the uterus, thus avoiding twin pregnancies. Ovarian tissue from young girls with Turner's syndrome could be cryopreserved for infertility treatment in the future, but the optimal age of ovarian biopsy has to be studied, and methods of replantation and maturation of oocytes in vitro have still to be developed. Fertility counseling has become important in the treatment of girls with Turner's syndrome.