Turner's syndrome and fertility: current status and possible putative prospects

Women with Turner's syndrome should be carefully followed throughout life. Growth hormone therapy should be started at age 2-5 years. Hormone replacem ent therapy for the development of normal female sexual characteristics sho uld be started at age 12-15 years and continued for the long term to preven t coronary artery disease and osteoporosis. Most women with Turner's syndro me have ovarian dysgenesis; therefore, they are usually infertile, and in v ery rare cases have spontaneous menses followed by early menopause. Only 2% of the women have natural pregnancies, with high rates of miscarriages, st illbirths and malformed babies. Their pregnancy rate in oocyte donation pro grammes is 24-47%, but even these pregnancies have a high rate of miscarria ge, probably due to uterine factors. A possible future prospect is cryopres ervation of ovarian tissue containing immature follicles before the onset o f early menopause, but methods of replantation and in-vitro maturation stil l need to be developed. Should these autologous oocytes indeed be used in t he future, affected women would need to undergo genetic counselling before conception, followed by prenatal assessment.