Endocrine Abstracts (2017) 49 EP1145 | DOI: 10.1530/endoabs.49.EP1145

Oocyte donation in women with Turner's syndrome: successful outcome can be achieved with a specialist multidisciplinary approach

Matilde Calanchini1,3, Kathy Baker2, Andrea Fabbri3, Ashley Grossman1, Elizabeth Orchard4, Tim Child2 & Helen Turner1

1Oxford Centre for Diabetes, Endocrinology and Metabolism – Churchill Hospital, University of Oxford, Oxford, UK; 2Oxford Fertility Institute of Reproductive Sciences, Oxford, UK; 3Department of Endocrinology CTO Alesini & S. Eugenio, University of Rome Tor Vergata, Rome, Italy; 4Cardiology Unit, John Radcliffe Hospital, Oxford, UK.

Introduction: Although oocyte donation (OD) is increasingly utilised in women with Turner’s syndrome (TS) few data are available. Reported clinical pregnancy rates following OD range from 17 to 40%. Complications of 2% death from aortic dissection and severe hypertension are reported.

Aim: To analyse the OD-pregnancy success rate and materno-fetal outcomes in women followed in a TS-dedicated centre.

Methods: A retrospective study of 114 adult TS patients analysed cardiovascular risk factors, feto-maternal morbidity and mortality in women undergoing OD (1997–2015). Data were compared with spontaneous pregnancy (SP) 14/114 patients, mean age 24 years (Calanchini et al. 2016, for SP data comparison).

Results: Eleven patients underwent egg donation cycles (total 27) using fresh (16) or frozen (3) donated eggs or embryos frozen and stored from a previous egg donation cycles (8). Endometrial preparation achieved endometrial thickness ≥7.3 mm, mean 10.2 mm. 1 or 2 embryos were transferred between day 2 and 5. Mean recipient age at first IVF was 32.5 years (24–41) and at delivery 33.8 years (26–41). 3/11 were 45X, 3/11 were 45X/46XY and 5/11 other TS-karyotypes. Five had cardiovascular malformations (4 bicuspid aortic valve, 1 treated aortic coarctation), four treated hypertension, and two pre-existing aortic dilatation. 12/27 (44%) cycles had positive pregnancy-tests and 5/27 (19%) resulted in live births. The cumulative live birth rate per patient undergoing treatment was therefore 5/11(46%). Increased aortic diameter occurred in 1/5, and gestational-diabetes 1/5. No patient developed gestational-hypertension compared with 7% SP. No cardiovascular or fetal complications were noted. One emergency caesarean section (37+1w, twin pregnancy).

Conclusions: OD showed a 19% live birth rate per cycle and 46% per patient in TS, was safe even in women with cardiac risk factors, and unassociated with increased feto-maternal complications compared with TS SP. This emphasises the importance of early discussion of assisted reproductive technology and alongside monitoring in a TS-dedicated multidisciplinary centre.

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