L Strypstein1, E Van Moer1, J Nekkebroeck1, I Segers1, H Tournaye1,2, I Demeestere3,4, M-M Dolmans5,6, W Verpoest1,7, M De Vos8,9,10. 1. Brussels IVF, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium. 2. Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, Sechenov University, Moscow, Russia. 3. Department of Obstetrics and Gynecology, Hôpital Erasme, Université Libre de Bruxelles, Fertility Clinic, Brussels, Belgium. 4. Research Laboratory On Human Reproduction, Université Libre de Bruxelles, Brussels, Belgium. 5. Gynecology Research Unit, Institut de Recherche Experimentale Et Clinique, Université Catholique de Louvain, Brussels, Belgium. 6. Department of Gynecology, Cliniques Universitaires Saint-Luc, Brussels, Belgium. 7. Reproductive Genetics Research Group, Vrije Universiteit Brussel, Brussels, Belgium. 8. Brussels IVF, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium. mdevos@uzbrussel.be. 9. Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, Sechenov University, Moscow, Russia. mdevos@uzbrussel.be. 10. Follicular Biology Research Group, Vrije Universiteit Brussel, Brussels, Belgium. mdevos@uzbrussel.be.
Abstract
PURPOSE: To report the case of a young woman diagnosed with Turner syndrome (TS) who achieved a live birth using her own oocytes that had been vitrified for fertility preservation. METHODS: A 25-year-old woman with mosaic (45,X/46,XX) TS was referred for fertility preservation (FP) counseling. Serum anti-Müllerian hormone (AMH) level was normal (6.4 µg/L). In view of the unpredictable rate of follicle loss in TS individuals, she requested FP and underwent two cycles of ovarian stimulation (OS) for oocyte cryopreservation (OoC) using a GnRH antagonist protocol and recombinant follicle stimulating hormone (rFSH), 200-250 IU daily for 8 resp. 12 days. RESULTS: In total, 29 metaphase II oocytes (MII) were vitrified after OS. After conceiving spontaneously and achieving a live birth, she returned to the clinic five years after OoC with a desire for pregnancy using in vitro fertilization (IVF) of her cryopreserved oocytes and preimplantation genetic testing (PGT-A). All 29 MII oocytes were thawed; 23 oocytes survived (79.3%) and were inseminated with partner sperm using intracytoplasmic sperm injection (ICSI). Thirteen oocytes were fertilized resulting in three good quality blastocysts which were vitrified after trophectoderm biopsy for PGT-A using array-CGH. Two blastocysts were found to be euploid. One was thawed and transferred to the uterus using a HRT priming protocol. An uneventful pregnancy occurred. The patient delivered a healthy baby girl weighing 3490 g at 40 weeks of gestation. CONCLUSIONS: We report the first live birth achieved using cryopreserved oocytes in a woman diagnosed with mosaic TS. Cryopreservation of oocytes after ovarian stimulation is a realistic option for FP in selected post menarche individuals with mosaic TS. Whether PGT-A may reduce the risk of pregnancy loss in TS has to be confirmed by further studies.
PURPOSE: To report the case of a young woman diagnosed with Turner syndrome (TS) who achieved a live birth using her own oocytes that had been vitrified for fertility preservation. METHODS: A 25-year-old woman with mosaic (45,X/46,XX) TS was referred for fertility preservation (FP) counseling. Serum anti-Müllerian hormone (AMH) level was normal (6.4 µg/L). In view of the unpredictable rate of follicle loss in TS individuals, she requested FP and underwent two cycles of ovarian stimulation (OS) for oocyte cryopreservation (OoC) using a GnRH antagonist protocol and recombinant follicle stimulating hormone (rFSH), 200-250 IU daily for 8 resp. 12 days. RESULTS: In total, 29 metaphase II oocytes (MII) were vitrified after OS. After conceiving spontaneously and achieving a live birth, she returned to the clinic five years after OoC with a desire for pregnancy using in vitro fertilization (IVF) of her cryopreserved oocytes and preimplantation genetic testing (PGT-A). All 29 MII oocytes were thawed; 23 oocytes survived (79.3%) and were inseminated with partner sperm using intracytoplasmic sperm injection (ICSI). Thirteen oocytes were fertilized resulting in three good quality blastocysts which were vitrified after trophectoderm biopsy for PGT-A using array-CGH. Two blastocysts were found to be euploid. One was thawed and transferred to the uterus using a HRT priming protocol. An uneventful pregnancy occurred. The patient delivered a healthy baby girl weighing 3490 g at 40 weeks of gestation. CONCLUSIONS: We report the first live birth achieved using cryopreserved oocytes in a woman diagnosed with mosaic TS. Cryopreservation of oocytes after ovarian stimulation is a realistic option for FP in selected post menarche individuals with mosaic TS. Whether PGT-A may reduce the risk of pregnancy loss in TS has to be confirmed by further studies.
Authors: Linn Salto Mamsen; Karol Charkiewicz; Richard A Anderson; Evelyn E Telfer; Marie McLaughlin; Thomas W Kelsey; Stine G Kristensen; Debra A Gook; Erik Ernst; Claus Yding Andersen Journal: Fertil Steril Date: 2019-03-25 Impact factor: 7.329
Authors: Claus H Gravholt; Niels H Andersen; Gerard S Conway; Olaf M Dekkers; Mitchell E Geffner; Karen O Klein; Angela E Lin; Nelly Mauras; Charmian A Quigley; Karen Rubin; David E Sandberg; Theo C J Sas; Michael Silberbach; Viveca Söderström-Anttila; Kirstine Stochholm; Janielle A van Alfen-van derVelden; Joachim Woelfle; Philippe F Backeljauw Journal: Eur J Endocrinol Date: 2017-09 Impact factor: 6.664