Pregnancies after oocyte donation in women with ovarian failure caused by an inactivating mutation in the follicle stimulating hormone receptor.
BACKGROUND
An inactivating point mutation (Ala189Val) in the FSH receptor (FSHR) causes primary ovarian failure. It has not been known if FSH action is necessary during pregnancy and childbirth.


METHODS
In 1991-2001, donated oocytes were used to treat the infertility of 12 women with ovarian failure due to this mutation.


RESULTS
When 30 fresh and 15 frozen-thawed embryo transfers were performed, 14 clinical and two biochemical pregnancies resulted. To date, 12 children have been born to eight women, while one pregnancy ended in miscarriage. Three women had twin pregnancies, and one woman has delivered twice. Additionally, there are three ongoing pregnancies, of which two are second pregnancies of women who previously had a normal delivery after similar treatment. In all, 10 out of the 12 women became pregnant. Two deliveries were by Caesarean section. The rate of complications was comparable with that in pregnancies resulting from oocyte donation in general.


CONCLUSIONS
Achieving and undergoing a successful pregnancy is possible when FSH action is severely decreased. Oocyte donation is an effective infertility treatment for women with FSHR mutations.
Hovatta
Outi
O
Department of Obstetrics and Gynaecology, Karolinska Institutet, Huddinge University Hospital, Sweden. outi.hovatta@klinvet.ki.se
Söderström-Anttila
Viveca
V
Foudila
Tuija
T
Tuomivaara
Leena
L
Juntunen
Kaisa
K
Tiitinen
Aila
A
Aittomäki
Kristiina
K
D000328:Adult; D004624:Embryo Transfer; D005260:Female; D005387:Finland; D006801:Humans; D007247:Infertility, Female / Q000235:genetics / Q000628:therapy*; D008875:Middle Aged; D018587:Oocyte Donation; D017354:Point Mutation; D011247:Pregnancy; D011256:Pregnancy Outcome; D016649:Primary Ovarian Insufficiency / Q000235:genetics*; D011962:Receptors, FSH / Q000235:genetics*; D014427:Twins
D011962:Receptors, FSH