Human Reproduction, Vol 12, 279-285, Copyright © 1997 by Oxford University Press
G Khastgir, H Abdalla, A Thomas, L Korea, L Latarche and J Studd
A total of 29 women with Turner's syndrome (19 monosomy and 10 mosaic) had
68 cycles of oocyte donation that included 29 cycles of initial attempt and
39 cycles of subsequent attempts. Oral oestradiol valerate was used either
in a variable dose (42 cycles) or in a constant dose (26 cycles) regimen
for the endometrial preparation which was monitored by pelvic
ultrasonography. The embryos/zygotes were transferred either fresh (50
cycles) or after cryopreservation (18 cycles) into the Fallopian tube (41
cycles) and uterine cavity (27 cycles) as appropriate. There were 28
clinical pregnancies including two sets of triplets resulting in a
pregnancy rate of 41.2% per treatment cycle and an implantation rate of
17.1% per embryo transferred. The recipient's age, chromosomal constitution
or associated uterine or tubal anomaly had no influence on the treatment
outcome. The implantation and pregnancy rates were higher in the subsequent
than initial cycles (22.6 versus 9.99%, P < 0.05; 51.3 versus 27.6%, P
< 0.05). An endometrial thickness of > or = 6.5 mm was an important
predictor of pregnancy but the endometrial echo pattern failed to predict
the outcome. Although the total dose of oestradiol before embryo transfer
was higher in the pregnant cycles than the non-pregnant ones and its
gradation (< 50 mg, 50-100 mg, < 100 mg) influenced the implantation
(3.4, 17.5, 26.3% respectively, P < 0.05) and pregnancy rates (10, 42.2,
61.5% respectively, P < 0.05), the effect was indirect by altering the
endometrial thickness. The number of oocytes fertilized affected the
pregnancy rate irrespective of the number of embryos transferred. The
implantation and pregnancy rates were higher when fresh rather than
frozen-thawed embryos were transferred (20.3 versus 8.2%, P < 0.05; 48
versus 22.2%, P < 0.05) but the route of transfer was of no statistical
importance. The overall miscarriage rate was higher (50%), and was related
to the presence of hypoplastic or bicornuate uterus and to a low oocyte
fertilization rate.
ARTICLES
Oocyte donation in Turner's syndrome: an analysis of the factors affecting the outcome
Fertility and Endocrinology Centre, Lister Hospital, London, UK.
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