Search

Study Question: What are the obstetric and neonatal outcomes of deliveries after oocyte donation (OD) in women with Turner syndrome (TS)?, Summary Answer: Pregnancies among women with TS carry a substantial risk, particularly for hypertensive disorders. Potentially life-threatening complications occurred in 3.3% of pregnancies. The neonatal outcomes were generally reassuring, with similar rates of preterm birth and low birthweight (LBW) as after conventional IVF and better than previously reported in deliveries after OD in women with TS., What Is Known Already: OD pregnancies in women with TS are known to be high-risk pregnancies., Study Design, Size, Duration: This retrospective cohort study included 106 women with TS who delivered after OD (n = 122 deliveries, n = 131 newborns) in three Nordic countries (Finland, Denmark, Sweden) between 1992 and 2011., Participants, Setting and Methods: Women with TS who delivered after OD in three Nordic countries were identified (n = 110). Four women declined to participate or were lost to follow-up, thus 106 women were included in the study. The medical data from fertility clinics, antenatal clinics and the hospitals where the women had been treated and/or delivered were scrutinized., Main Results and the Role of Chance: In this cohort, the karyotype was 45,X in 44% of the women with TS. Ten women (9.4%) had a known cardiac defect before pregnancy. Single embryo transfer was performed in 70.3% of the cases and the multiple birth rate was 7.4%. In total, 35.0% of the pregnancies were associated with a hypertensive disorder including pre-eclampsia in 20.5%. Potentially life-threatening complications occurred in four pregnancies (3.3%), including one woman with aortic dissection, one with mild regurgitation of the tricuspid and mitral valve, one with a mechanical heart valve who developed HELLP syndrome (haemolysis, elevated liver enzymes, low platelets) and one who underwent a post-partum hysterectomy due to severe haemorrhaging. Neonatal outcomes were reassuring, with a preterm birth rate of 8.0% and LBW rate of 8.8% in singletons. Major birth defects were found in 3.8% of the children. The perinatal mortality was 2.3% (3/131), including a set of extremely preterm twins., Limitations, Reasons for Caution: Although this study was performed over a period of almost 20 years in three different countries, with a low drop-out rate and little missing data, much larger series are needed to assess rare events. This study also lacks an appropriate control group., Wider Implications of the Findings: This study suggests that cardiovascular evaluation before and during pregnancy may contribute to favourable obstetric outcomes in many cases. Maternal outcomes were in agreement with the literature while neonatal outcomes were generally better than previously reported. The outcomes were consistent across the three countries, supporting generalizability to similar populations.

Oocyte donation is an effective solution for treating infertile women whose ovaries are non-functional. This infertility condition is known as premature ovarian failure and is most commonly caused by genetic or autoimmune diseases, chemo- or radiotherapy, severe endometriosis and ovarian cancer. Oocyte donation also benefits those women who have functional ovaries yet respond poorly to ovarian hyperstimulation for in vitro fertilisation. Not only does oocyte donation provide healthy oocytes to infertile women, it also allows any genetic diseases of the recipient to be avoided. The process is simple beginning with ovarian hormonal stimulation of the donor followed by trans-vaginal oocyte retrieval. The mature oocytes are then fertilised with the sperm of the recipient's partner and the resulting embryo is transferred to the uterus two to five days later. Careful counselling of all parties involved is necessary before commencing treatment. International experience using oocyte donation has been excellent revealing normal, healthy relationships between the children and their families. Until now, oocyte donation has been illegal in Sweden, yet on 25th April 2002 the Swedish Parliament accepted a change in the law regarding assisted reproduction. According to this new law, oocyte donation will be permitted in Sweden from the beginning of January 2003 providing new hope for infertile couples.