Assessment of ovarian reserve in children and adolescents with Turner’s syndrome

DOI

https://dx.doi.org/10.18565/aig.2022.6.40-49

Uvarova E.V., Turchinets A.I., Kumykova Z.Kh., Pivovarova O.Yu.
1) Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, Moscow, Russian Federation; 2) I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russian Federation; 3) N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Department of Obstetrics and Gynecology, Faculty of Pediatrics, Moscow, Russian Federation

Premature ovarian failure affects the majority of female patients with Turner’s syndrome and therefore only 5–10% is observed to have regular menstruation, whereas spontaneous pregnancy occurs in only 2% of women with this syndrome mostly at a young age and generally in patients with mosaic karyotype. Girls with Turner’s syndrome are noted to have a reduced pool of oogonia in the primary gonads and primordial follicles just at birth, which is concurrent with subsequent postnatal loss of gametes, leads to ovarian reserve depletion before reaching reproductive maturity in 90% of patients. Fertility preservation in this cohort of patients is potentially feasible because many girls with Turner’s syndrome retain ovarian follicles until adolescence. Biochemical markers that reflect childhood ovarian reserve and predict the degree of ovarian impairment are needed to identify candidates among girls and adolescents with Turner’s syndrome, as well as the timing of fertility preservation procedures. The paper reviews current information on the assessment of ovarian reserve in girls with Turner’s syndrome, considers the relationship of the ovarian reserve to the karyotype, and describes the results of ovarian tissue biopsy, as well as the experience with assisted reproductive technologies and cryopreservation to achieve pregnancy in these patients in the future.
Conclusion: An early assessment of ovarian reserve before the age of 10 years should be made, by taking into account the karyotype, FSH, AMH and inhibin B levels, spontaneous menarche and puberty, in order to timely consider possible options for preserving fertility.

Turner’s syndrome

ovarian reserve

premature ovarian failure

fertility preservation

cryopreservation

Full text (in Russian)

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База данных клинических исследований, финансируемых из частных и государственных источников по всему миру, ClinicalTrials.gov. [Database of clinical trials funded from private and public sources around the world, ClinicalTrials.gov]. Available at: https://clinicaltrials.gov/ct2/show/NCT03381300
База данных клинических исследований, финансируемых из частных и государственных источников по всему миру, ClinicalTrials.gov. [Database of clinical trials funded from private and public sources around the world, ClinicalTrials.gov]. Available at: https://clinicaltrials.gov/ct2/show/NCT04189406

Received 21.03.2022

Accepted 28.03.2022

Elena V. Uvarovа, Corresponding Member of the RAS, Dr. Med. Sci., Professor at the Department of Obstetrics, Gynecology and Perinatology, First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); Head of the Department of Pediatric and Adolescent Gynecology, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, elena-uvarova@yandex.ru, https://orcid.org/0000-0002-3105-5640,
117997, Russia, Moscow, Ac. Oparin str., 4.
Anna I. Turchinets, resident at the Department of Obstetrics and Gynecology, Pediatric Faculty, Pirogov Russian National Research Medical University, Ministry of Health of Russia, +7(926)522-87-39, Ponomarevaanna28@gmail.com, https://orcid.org/0000-0002-4478-9133, 117997, Russia, Moscow, Ostrovitianov str., 1.
Zaira Kh. Kumykova, PhD, Senior Researcher at the Departament of Pediatric and Adolescent Gynecology, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, zai-kumykova@yandex.ru, https://orcid.org/0000-0001-7511-1432,
117997, Russia, Moscow, Ac. Oparin str., 4.
Oksana Yu. Pivovarova, PhD, Associate Professor at the Department of Obstetrics and Gynecology, Pediatric Faculty, Pirogov Russian National Research Medical University, Ministry of Health of Russia, pou@mail.ru, https://orcid.org/0000-0002-8957-3248, 117997, Russia, Moscow, Ostrovitianov str., 1.
Corresponding author: Anna I. Turchinets, Ponomarevaanna28@gmail.com

Authors' contributions: Uvarova E.V., Turchinets A.I. – concept and design of the investigation, data analysis; Pivovarova O.Yu., Turchinets A.I. – material collection and processing; Kumykova Z.Kh., Turchinets A.I. – writing the text; Uvarova E.V., Kumykova Z.Kh., Pivovarova O.Yu. – editing.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The investigation has been conducted without additional funding.
For citation: Uvarova E.V., Turchinets A.I., Kumykova Z.Kh., Pivovarova O.Yu.
Assessment of ovarian reserve in children and adolescents with Turner’s syndrome.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 6: 40-49 (in Russian)
https://dx.doi.org/10.18565/aig.2022.6.40-49

Assessment of ovarian reserve in children and adolescents with Turner’s syndrome

Uvarova E.V., Turchinets A.I., Kumykova Z.Kh., Pivovarova O.Yu.

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