[Turner's syndrome and oocyte donation].
This paper reviews literature about oocyte donation for patients with Turner's syndrome and reports the experience of our center. Before contemplating pregnancy, it is essential to perform a careful evaluation of the cardiovascular system, the renal system, the thyroid status and the glucose tolerance. Different studies have reported a suboptimal response of the endometrium of women with Turner's syndrome to oestrogen therapy, and suggested that higher doses of estrogens may be necessary to achieve appropriate endometrial preparation. Pregnancy rate per transfer following oocyte donation is around 30% for patients with Turner's syndrome, comparable to the one observed for patients with other conditions requiring oocyte donation. Miscarriage rate is however higher (40-50%) after oocyte donation in Turner's syndrome, and could be related to the presence of a hypoplastic uterus along with hypovascularization. During pregnancy, cardiovascular complications are potentially the most severe, such as the exacerbation of a preexisting hypertension and the dissection of aortic aneurysms. There is a high rate of Caesarean section among Turner's syndrome patients, the main reason being fetopelvic disproportion. Regarding the increased obstetrical risks in Turner's syndrome patients, the selective transfer of one embryo should ideally be performed in order to avoid additional risks associated with multiple pregnancies. In our center, 9 patients with a Turner's syndrome had 15 cycles of oocyte donation. Five pregnancies were obtained among which three were evolutive. The outcome of oocyte donation cycles were comparable for patients with a Turner's syndrome and for patients with other indications of oocyte donation.
Delbaere
A
A
Clinique de fertilité, hôpital Erasme, Université libre de Bruxelles, 808, route de Lennik, 1070 Bruxelles, Belgique. adelbaer@ulb.ac.be
Englert
Y
Y
D000022:Abortion, Spontaneous / Q000453:epidemiology; D004624:Embryo Transfer; D004717:Endometrium / Q000503:physiopathology; D005260:Female; D006801:Humans; D018587:Oocyte Donation; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D014424:Turner Syndrome / Q000150:complications / Q000503:physiopathology