title: Fertility preservation in Turner syndrome.
abstract: Premature ovarian insufficiency is a relatively rare condition that can appear early in life. In a non-negligible number of cases the ovarian dysfunction results from genetic diseases. Turner syndrome (TS), the most common sex chromosome abnormality in females, is associated with an inevitable premature exhaustion of the follicular stockpile. The possible or probable infertility is a major concern for TS patients and their parents, and physicians are often asked about possible options to preserve fertility. Unfortunately, there are no recommendations on fertility preservation in this group. The severely reduced follicle pool even during prepubertal life represents the major limit for fertility preservation and is the root of numerous questions regarding the competence of gametes or ovarian tissue crybanked. In addition, patients suffering from TS show higher than usual rates of spontaneous abortion, fetal anomaly, and maternal morbidity and mortality, which should be considered at the time of fertility preservation and before reutilization of the cryopreserved gametes. Apart from fulfillment of the desire of becoming genetic parents, TS patients may be potential candidates for egg donation, gestational surrogacy, and adoption. The present review discusses the different options for preserving female fertility in TS and the ethical questions raised by these approaches.
authors.affiliation: Department of Reproductive Medicine, Hôpital Jean Verdier, Assistance Publique-Hôpitaux de Paris, Bondy, France; University Paris XIII, Bobigny, France; Unité Inserm (U1133), University Paris-Diderot, Paris, France. Electronic address: michael.grynberg@aphp.fr.
authors.forename: Michaël
authors.initials: M
authors.lastname: Grynberg
authors.affiliation: Pediatric Endocrinology, Gynecology and Diabetology, Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Centre des Maladies Endocrines Rares de la Croissance, Centre des Pathologies Gynécologiques Rares, Paris, France.
authors.forename: Maud
authors.initials: M
authors.lastname: Bidet
authors.affiliation: Department of Reproductive Medicine, Hôpital Jean Verdier, Assistance Publique-Hôpitaux de Paris, Bondy, France; University Paris XIII, Bobigny, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Benard
authors.affiliation: Department of Reproductive Biology, Hôpital Courbevoie-Neuilly-Puteaux, Neuilly sur Seine, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Poulain
authors.affiliation: Department of Reproductive Medicine, Hôpital Jean Verdier, Assistance Publique-Hôpitaux de Paris, Bondy, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Sonigo
authors.affiliation: Department of Reproductive Medicine, Hôpital Jean Verdier, Assistance Publique-Hôpitaux de Paris, Bondy, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Cédrin-Durnerin
authors.affiliation: Pediatric Endocrinology, Gynecology and Diabetology, Hôpital Universitaire Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Centre des Maladies Endocrines Rares de la Croissance, Centre des Pathologies Gynécologiques Rares, Paris, France; Université Paris Descartes, Institut IMAGINE, Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Polak
mesh_terms: D000300:Adoption; D015925:Cryopreservation; D004624:Embryo Transfer; D005260:Female; D005298:Fertility / Q000235:genetics; D059247:Fertility Preservation / Q000009:adverse effects / Q000941:ethics / Q000379:methods*; D005307:Fertilization in Vitro; D020022:Genetic Predisposition to Disease; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D010053:Ovary / Q000637:transplantation; D010641:Phenotype; D011247:Pregnancy; D016649:Primary Ovarian Insufficiency / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology*; D012307:Risk Factors; D013533:Gestational Carriers; D016896:Treatment Outcome; D014424:Turner Syndrome / Q000150:complications* / Q000175:diagnosis / Q000235:genetics
keywords: Fertility preservation; Turner syndrome; oocyte vitrification; ovarian tissue cryopreservation