Endocrine Abstracts (2019) 65 P361 | DOI: 10.1530/endoabs.65.P361

Options for childbearing and pregnancy outcomes in Turner syndrome

Christina Y L Aye1,2, Matilde Calanchini3,4, Kathy Baker5, Tim Child5, Annabelle Frost6, Andrea Fabbri4, Lucy Mackillop1,2 & Helen E Turner3

1Women’s Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; 2Nuffield Department of Women’s and Reproductive Health, John Radcliffe Hospital, Oxford, UK; 3Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University Hospital NHS Trust, Oxford, UK; 4Department of Systems Medicine, Endocrinology & Metabolism Unit, University of Rome Tor Vergata, Rome, Italy; 5Oxford Fertility Institute of Reproductive Sciences, Oxford, UK; 6Obstetric and Gynaecology Department, Stoke Mandeville Hospital, Aylesbury, UK

Spontaneous pregnancy (SP) in TS is rare (4.8–7.6%). Oocyte-donation-in-vitro-fertilization (IVF-OD) and fertility-preservation increasingly offer the possibility of childbearing. Nevertheless, pregnancy is associated with an increased risk of complications. Adoption/surrogacy represents alternative parenting options.

Aim: To analyse parenting options and pregnancy outcomes inTS.

Methods: Data was collected in 154 TSwomen, median age 32y, including parenting options, method of conception and birth outcomes.

Results: 21 (13.6%) had SP, 48% ≥one miscarriage; 35 newborns were delivered by 18 women. Age at first SP was 23.8y (15–31); 4 women had unwanted pregnancies. All women with SP had spontaneous menarche, 61.1% were mosaic 45,X/46,XX, 11.1% 45,X. SP-complications; 2 women developed preeclampsia, 2 gestational diabetes. 1/35 offspring had TS. Among women with no SP (136), 15.4% considered IVF-OD. 4 women were unable to proceed with IVF-OD: 2 aged>35y not eligible for funding, one increased BMI, one increased cardiac-risks. 14 women received 39 cycles, age at first IVF-OD was 31.2y; 7 delivered 9 newborns and 7 stopped trying after unsuccessful attempts/miscarriages. Despite guidelines recommending single embryo-transfer, 4 women received two embryo-transfer (2 recently outside UK due to lack of funding); 2 pairs of twins were delivered, 2 started with twin pregnancies, one resulting in the miscarriage of one and the other both twins. IVF-OD complications; 2 developed gestational diabetes. 3 considered adoption; one adopted, one with increased cardiac-risk has started the process, one withdrew (too intrusive) and is investigating surrogacy. One aged 17y had oocyte-cryopreservation with successful oocyte retrieval. Four were not interested in childbearing.

Conclusions: This is the first study focusing on fertility options in TS. We found a higher prevalence of SP compared to previous studies. IVF-OD was successful in half who attempted and we emphasize the importance of single embryo-transfer to avoid complications. Overall, pregnancy outcomes were good in both SP and IVF-OD.

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