DuoStim: a new option for fertility preservation for a woman with Turner syndrome

Abstract

Introduction

Turner syndrome (TS) is associated with hypergonadotropic hypogonadism due to gonadal dysgenesis, which results in premature ovarian failure and subsequent infertility. Therefore, counseling and evaluation for fertility preservation are required as early as possible for women with TS.

Case presentation

A 23-year-old unmarried woman with mosaic TS (45, X [4/30] 46, XX [26/30]) presented to the pediatric department of our hospital for fertility counseling; she was accompanied by her mother. She was referred to the reproduction center of our hospital for ovarian reserve assessment and counseling regarding fertility preservation. We decided to retrieve oocytes using DuoStim as the controlled ovarian stimulation protocol. During the first and second oocyte retrievals, a total of 17 (9 and 8, respectively) mature metaphase II oocytes were cryopreserved.

Conclusion

DuoStim may be a useful option for fertility preservation for women with TS and reduced ovarian reserve. This new strategy may obtain the required number of oocytes in the shortest time and preserve the future fertility of women with TS.

摘要

特纳综合征（TS）由于性腺发育不良导致体内促性腺激素升高, 容易导致早发性卵巢功能不全以及不孕症。因此, 对于TS患者, 尽早进行生育能力的评估及咨询是非常必要的。病例介绍：一位23岁TS女性, 未婚, 染色体为嵌合体：TS（45, X [4/30] ；46, XX[26/30]）, 由母亲陪同来我院就诊进行生育咨询。她被转诊到我们医院的生殖中心进行卵巢储备评估以及生育力保护的咨询。我们决定采用DuoStim双促排卵的方式作为控制超促排卵的方案。在第一次和第二次取卵中, 共取了17个成熟II期的卵母细胞进行冷冻保存（第1次9个, 第2次8个）。结论：对于卵巢储备功能下降的TS患者, DuoStim双促排卵方案可能是保存生育力的一种有效方案。这种新的促排卵方案可以在很短的时间内获得所需要的卵母细胞, 并能够保护TS患者未来的生育能力。

Keywords:

• Double stimulation
• dual ovarian stimulation
• progestin-primed ovarian stimulation
• random-start
• fertility preservation
• sex chromosome
• abnormality;
• oncofertility
• ovarian stimulation

Acknowledgements

The authors thank all staff of the Reproduction Center of Toho University Omori Medical Center.

Authors’ contributions

Treatment was performed by Ayumu Ito, Ayako Oji and Yukiko Katagiri. The first draft of the manuscript was written by Ayumu Ito. All authors commented on the previous version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).