Algorithmic approach to decision-making for fertility preservation in girls and women with Turner syndrome
A proposed algorithmic approach to decision-making for fertility preservation in females diagnosed with Turner syndrome. For prepubertal girls with sufficient ovarian reserve, expert experience dictates utility of serial serum AMH assessments to delay intervention to a postpubertal age, so that oocyte cryopreservation can be considered. Serum AMH level of ≤2 ng/mL corresponds to levels in the lower quartile for girls 5 to 13 years of age[1]. In postpubertal girls, because the risk of follicle loss is extremely high and can proceed at a fast pace, we recommend fertility preservation regardless of the initial AMH.
Reference:
- Purushothaman R, Lazareva O, Oktay K, et al. Markers of ovarian reserve in young girls with Turner's syndrome. Fertil Steril 2010; 94:1557.
Reproduced from: Oktay K, Bedoschi G, Berkowitz K, et al. Fertility Preservation in Women with Turner Syndrome: A Comprehensive Review and Practical Guidelines. J Pediatr Adolesc Gynecol 2016; 29:409. Illustration used with the permission of Elsevier Inc. All rights reserved.