Oocyte cryopreservation in a woman with mosaic Turner syndrome: a case report.
BACKGROUND
Turner syndrome (TS) is the most common sex chromosome anomaly. Spontaneous pregnancies have been reported in a small percentage of women with TS, particularly those with mosaicism. However, due to accelerated follicular atresia, the majority of TS patients undergo ovarian failure prior to or around the time of puberty. In vitro fertilization with donor oocytes and subsequent embryo transfer has been the predominant fertility option for such patients. We report a case of oocyte cryopreservation for a patient with mosaic TS including the evaluation, treatment decisions and ovarian response.


METHODS
A 28-year-old woman with mosaic TS and oligomenorrhea chose oocyte cryopreservation for fertility preservation. Ovarian reserve testing revealed a day 3 FSH of 4.3 mIU/mL and an antral follicle count of 40. She underwent controlled ovarian stimulation and had a vigorous response to a gonadotropin/gonadotropin-releasing hormone antagonist protocol, with a peak estradiol level of 4507 pg/mL. Transvaginal oocyte retrieval produced 15 oocytes, 13 of which met the criteria for vitrification.


CONCLUSIONS
Oocyte cryopreservation offers TS patients a new option to preserve future fertility; however, this new technology requires extensive counseling regarding not only its investigational nature but also risks specific to it and implications for this patient population.
Kavoussi
Shahryar K
SK
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan Health System, Ann Arbor, MI 48109-0276, USA. skavouss@med.umich.edu
Fisseha
Senait
S
Smith
Yolanda R
YR
Smith
Gary D
GD
Christman
Gregory M
GM
Gago
L April
LA
D000328:Adult; D015925:Cryopreservation; D003451:Cryoprotective Agents; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone; D007987:Gonadotropin-Releasing Hormone; D006801:Humans; D007247:Infertility, Female; D009030:Mosaicism; D009865:Oocytes; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D016649:Primary Ovarian Insufficiency; D014424:Turner Syndrome / Q000150:complications / Q000235:genetics*
D003451:Cryoprotective Agents; D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone