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J Clin Endocrinol Metab. 2009 Jan;94(1):74-80. doi: 10.1210/jc.2008-0708. Epub 2008 Oct 28.

Fertility preservation in girls with turner syndrome: prognostic signs of the presence of ovarian follicles.

Author information

  • 1Department of Pediatrics, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden. Birgit.borgstrom@ki.se

Erratum in

  • J Clin Endocrinol Metab. 2009 Apr;94(4):1478. Birgit, Borgström [corrected to Borgström, Birgit]; Julius, Hreinsson [corrected to Hreinsson, Julius]; Carsten, Rasmussen [corrected to Rasmussen, Carsten]; Maryam, Sheikhi [corrected to Sheikhi, Maryam]; Gabriel, Fried [corrected to Fried, Gabriel]; Victoria, Keros [corrected to Keros, Victoria]; Margareta, Fridström [corrected to Fridström, Margareta]; Outi, Hovatta [corrected to Hovatta, Outi].

Abstract

CONTEXT:

Many girls with Turner syndrome have follicles in their ovaries at adolescence.

OBJECTIVE:

Our objective was to study which girls might benefit from ovarian tissue freezing for fertility preservation.

DESIGN:

Clinical and laboratory parameters and ovarian follicle counts were analyzed among girls referred by 25 pediatric endocrinologists.

SUBJECTS AND SETTING:

Fifty-seven girls with Turner syndrome, aged 8-19.8 yr, were studied at a university hospital.

INTERVENTIONS:

Ovarian tissue was biopsied laparoscopically, studied for the presence of follicles, and cryopreserved. Blood samples were drawn for hormone measurements.

MAIN OUTCOME MEASURES:

Presence of follicles in the biopsied tissue related to age, signs of spontaneous puberty, karyotype, and serum concentrations of gonadotropins and anti-Müllerian hormone were assessed.

RESULTS:

Ovarian biopsy was feasible in 47 of the 57 girls. In 15 of the 57 girls (26%), there were follicles in the tissue piece analyzed histologically. Six of seven girls (86%) with mosaicism, six of 22 (27%) with structural chromosomal abnormalities, and three of 28 with karyotype 45X (10.7%) had follicles. Eight of the 13 girls (62%) with spontaneous menarche had follicles, and 11 of the 19 girls (58%) who had signs of spontaneous puberty had follicles. The age group 12-16 yr had the highest proportion of girls with follicles. Normal FSH and anti-Müllerian hormone concentrations for age and pubertal stage were more frequent in girls with follicles.

CONCLUSIONS:

Signs of spontaneous puberty, mosaicism, and normal hormone concentrations were positive and statistically significant but not exclusive prognostic factors as regards finding follicles.

PMID:
18957497
[PubMed - indexed for MEDLINE]
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