Spontaneous pregnancy (SP) in TS is rare (4.87.6%). 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 (1531); 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.