Fertility Preservation in Turner Syndrome

Karyotype Does Not Predict Ovarian Response to Stimulation

Julia Vergier; Pauline Bottin; Jacqueline Saias; Rachel Reynaud; Catherine Guillemain; Blandine Courbiere

Disclosures

Clin Endocrinol. 2019;91(5):646-651. 

In This Article

Materials and Methods

Methodology

Data were collected from the medical charts of women with TS who have been taken care in the Fertility Preservation Unit of Marseille, France. This retrospective study was approved by the Aix-Marseille University ethics committee (2019-25-04-001). Medical data use agreement was given by the freedoms and computer correspondent of our public hospital (n°2019_83). Oral and written informed consent were retrieved.

During medical consultation with a fertility counsellor, women were informed that (a) mature oocyte retrieval and cryopreservation were not guarantee after COS, (b) long-term outcome of FP strategies in women with TS is unknown and consistent data concerning live-birth–rate after oocyte reutilization in women with TS are missing (c) at our knowledge, no pregnancy in women with TS has been described after any FP procedure.

Controlled Ovarian Stimulation Protocol

Daily sub-cutaneous injections of recombinant follicle-stimulating hormone (Gonal-F®, Merck Serono; Bemfola®, Gedeon Richter; Puregon®, MSD) were used for controlled ovarian stimulation (COS). Individual pre-stimulation evaluation determined the initial starting dose. A GnRH antagonist (Orgalutran®, MSD) was co-administered to prevent LH surge at day 5 of COS. Ovarian response monitoring was assessed by repeated transvaginal ultrasounds measuring follicular growth and serum oestradiol levels. Oocyte maturation was triggered 36 hours prior retrieval with either recombinant human Chorionic Gonadotropin hCG (Ovitrelle®, Merck Serono) and/or 0.3 mg GnRH agonist (Decapeptyl 0.1 mg®, IPSEN Pharma). Transvaginal oocyte retrieval was performed using ultrasonographic guidance, under local or general anaesthesia depending on patient wish. Mature oocyte cryopreservation using vitrification was then performed (Vit Kit® Freeze, Irvine Scientific, JX Group).

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