Cryopreservation of Ovarian Cortex in Girls With Turner Syndrome
Cryopreservation of Ovarian Cortex in Girls With Turner Syndrome
Ovarian insufficiency is common in Turner syndrome related to premature and rapid follicular
 apoptosis and spontaneous pregnancies are rare in this population. Ovarian cryopreservation
 has been used in an effort to preserve fertility in patients undergoing treatments which lead
 to premature and severe ovarian insufficiency. This study aims to assess the relevance of
 ovarian tissue cryopreservation in girls with Turner syndrome. Based on ovarian follicular
 density as primary outcome and karyotypic, clinical and hormonal markers as secondary
 outcomes, analysis of the study will allow to select the patients to whom the procedure would
 benefit the most.
Turner syndrome (TS) is characterized by the absence of all or part of a normal second X
 chromosome and occurs in about 1/2,500 live-born girls. Spontaneous fertility is rare among
 patients with TS related to premature apoptosis of ovarian follicles. Spontaneous puberty and
 fertility has been reported mostly in patients with mosaic karyotype or small X deletions.

 There is robust evidence that follicles can be observed in ovaries in girls with TS. However,
 follicular density and quality seems to be largely influenced by karyotype, ovarian
 morphology and endocrine competence. There are no clear-cut clinical or hormonal markers to
 assess the ovarian reserve in girls with TS but markers of ovarian function used in women
 with premature ovarian insufficiency are measured. In TS, it is now fundamental to be able to
 evaluate the prognosis of the ovarian function and the degree of fertility to provide the
 relevant information to girls and their parents and to discuss possibilities of motherhood if
 any.

 Ovarian cryopreservation has been used in an effort to preserve fertility in patients
 undergoing treatments which lead to premature and severe ovarian insufficiency. This study
 aims to assess the relevance of ovarian tissue cryopreservation in girls with Turner
 syndrome. Based on ovarian follicular density as primary outcome and karyotypic, clinical and
 hormonal markers as secondary outcomes, analysis of the study will allow to screen the
 patients to whom the procedure would benefit the most.

 Girls who will be operated will accept to come for a follow-up visit at one and 12 months
 after the surgery. It is expected to have clinical and hormonal information through a long
 follow up performed by the referred paediatrician.

 Results of the study will allow us to select patients with TS who will benefit the most of
 this fertility preservation procedure based on karyotypic, clinical and hormonal profile.
Inclusion criteria :

 -  girls aged from 1 to 25 years included,

 -  with Turner syndrome or mosaic

 -  patients aged more than 18 will only have ovarian insufficiency dated less than 5
 years

 -  without any severe disease, particularly of cardiovascular type

 -  whose agreement to participate to the study has been signed by the parents

 -  whose agreement to participate to the study has been signed by majority age patient

 Exclusion criteria :

 -  girls aged less than one year and over 25 years old

 -  if any surgery would be contra-indicated

 -  ovary alone presence

 -  Well-known infection by HIV, and/or HBV, and/or HCV and/or syphilis TPHA VDRL

 -  No social coverage affiliate