Endocrine Abstracts

JOINT620

Turner syndrome is a chromosomic disease affecting 1 fetus in 2500. In more than 95% of cases, these patients have primary ovarian insufficiency (POI), consisting of premature cessation of ovarian function before the age of 40. When a pregnancy is expected, usually, in vitro fertilization (IVF) with oocyte donation is necessary. Current data suggest increased obstetric and perinatal morbidity for these pregnancies, such as hypertensive disorders. A retrospective monocentric cohort study was conducted in the reproduction medicine ward of the University Hospital Center of Lyon. The study population included all patients aged 18 to 40 who had received at least one embryo transfer after IVF with oocyte donation, in POI context, with or without Turner syndrome, from January 1, 2007 to December 31, 2023. 97 patients were included. Live birth rate, obstetrical and perinatal outcomes were compared between the 2 populations. Embryo transfer success (live birth) was conducted by adjusted logistic regression. Several odds-ratio were estimated, depending on the rank of transfer attempt. A purely descriptive analysis of obstetrical and perinatal data was conducted. 29% of the embryo transfers resulted in a live birth among the Turner patients, and 27% among the other POI patients. A statistically significant decrease of live birth rate in the first attempt among the Turner was seen, with an odds ratio at 0,09 (0,01; 0,64) and a p-value at 0,017. No statistical difference was noted for the third transfer and beyond, with a p-value at 0,095. The obstetrical and perinatal morbidity was high, with 70% of cesareans, 18,7% of premature births and 26% of non-cephalic fetal presentations for Turner patients. The retrospective nature of the study is responsible of selection bias. A more precise analysis of the obstetric outcomes would require distinguishing single-fetal pregnancies from multiple pregnancies, having their own morbidity. Live birth rates in our study are high, in line with lower miscarriage rates than usually found in the literature. The optimization of hormonal replacement therapy prior to ART course, and of the artificial cycle during embryo transfer seem to be plausible explanations of the better results. The obstetrical and perinatal morbidity is high, as expected.

Key words: Turner syndrome, primary ovarian insufficiency, oocyte donation, obstetrical outcomes.