Oocyte Freezing Following Ovulation Induction and Egg Retrieval in a 45x Teenage Girl with Hypergonadotropic Primary Amenorrhea, Estrogen Deficiency, and Sexual Infantilism

Although there have been some uncommon cases of spontaneous ovulation and even pregnancies in females with Turner’s syndrome, most have been Turner mosaics, but some do have the 45x karyotype. However, in all cases these women had normal sexual development. There are techniques to restore sensitivity of follicles to FSH by up-regulating down regulated FSH receptors. This technique was tried on a 13-year-old with 45X Turner’s syndrome with markedly elevated serum FSH, very low serum estradiol (E2) and sexual infantilism with the intent of banking an egg or two for future fertility purposes. Despite bilateral streaked gonads, she made a dominant follicle twice, once at age 13 and once at age 14. One egg was retrieved from each IVF cycle. The first egg was cryopreserved for the future whereas the second egg was discarded because it was degenerating. Thus, the FSH receptor up-regulation technique can even allow follicle maturation despite barely any ovarian tissue remaining on the urogenital ridges Possibly, once considering the pros and cons, if the parents and child wanted to bank eggs despite Turner’s syndrome, this should be considered at the youngest age possible.