Abstract：
OBJECTIVE: Many women with Turner syndrome (TS) will consider fertility options and pregnancy. We wished to examine the fertility and pregnancy outcomes in women with TS undergoing oocyte donation (OD) treatment or spontaneous pregnancy in a large single-centre cohort. General population reference data or data from those with idiopathic premature ovarian insufficiency were used as comparators.
METHODS: A retrospective single-centre cross-sectional study.
METHODS: Seventy-four women with TS underwent OD treatment with a total of 105 pregnancies, and 31 women with TS had 71 spontaneous conceptions. Fertility outcomes included clinical pregnancy and live birth rate. Pregnancy outcomes included miscarriage rate, prevalence of hypertension, gestational diabetes, lower segment caesarean section (LSCS), small for gestational age (SGA), prematurity and vertical transmission of TS.
RESULTS: In those with TS, OD pregnancies were associated with increased rates of LSCS and SGA compared to spontaneous pregnancies; LSCS (OR: 4.19, 95% CI: 1.6-10.8, p = .003) and SGA (OR: 2.92, 95% CI: 1.02-8.38, p = .04). There were no recorded cardiac events but 5 (17.2%) cases of vertical transmissions of TS in daughters were identified. OD in those with TS was associated with a lower live birth rate per cycle started (OR: 0.53, 95% CI: 0.34-0.84, p = .008) and a higher rate of miscarriage compared to women with POI (40% vs. 26.2%, p = .04).
CONCLUSIONS: We show that pregnancy in women with TS, whether OD or spontaneously conceived, carries obstetric risks, and therefore, women with TS, considering pregnancy, should receive comprehensive pre-pregnancy counselling and optimal obstetric care.
METHODS: A retrospective single-centre cross-sectional study.
METHODS: Seventy-four women with TS underwent OD treatment with a total of 105 pregnancies, and 31 women with TS had 71 spontaneous conceptions. Fertility outcomes included clinical pregnancy and live birth rate. Pregnancy outcomes included miscarriage rate, prevalence of hypertension, gestational diabetes, lower segment caesarean section (LSCS), small for gestational age (SGA), prematurity and vertical transmission of TS.
RESULTS: In those with TS, OD pregnancies were associated with increased rates of LSCS and SGA compared to spontaneous pregnancies; LSCS (OR: 4.19, 95% CI: 1.6-10.8, p = .003) and SGA (OR: 2.92, 95% CI: 1.02-8.38, p = .04). There were no recorded cardiac events but 5 (17.2%) cases of vertical transmissions of TS in daughters were identified. OD in those with TS was associated with a lower live birth rate per cycle started (OR: 0.53, 95% CI: 0.34-0.84, p = .008) and a higher rate of miscarriage compared to women with POI (40% vs. 26.2%, p = .04).
CONCLUSIONS: We show that pregnancy in women with TS, whether OD or spontaneously conceived, carries obstetric risks, and therefore, women with TS, considering pregnancy, should receive comprehensive pre-pregnancy counselling and optimal obstetric care.
摘要：
目标：许多患有特纳综合征（TS）的女性会考虑生育选择和怀孕。我们希望在大型单中心队列中检查接受卵母细胞捐赠（OD）治疗或自发性妊娠的TS女性的生育力和妊娠结局。一般人群参考数据或特发性早熟卵巢功能不全患者的数据用作比较。
方法：回顾性单中心横断面研究。
方法：74名患有TS的妇女接受了OD治疗，总共105次怀孕，31名TS女性有71个自发概念。生育结局包括临床妊娠和活产率。妊娠结局包括流产率，高血压患病率，妊娠期糖尿病,下段剖宫产术（LSCS），小于胎龄（SGA），TS的早产和垂直传播。
结果：在有TS的人中，与自发性妊娠相比，OD妊娠与LSCS和SGA的发生率增加相关；LSCS（OR：4.19，95％CI：1.6-10.8，p=.003）和SGA（OR：2.92，95％CI：1.02-8.38，p=.04）。没有记录的心脏事件，但发现了5例（17.2％）女儿中TS的垂直传播。与POI女性相比，TS患者的OD与每个周期开始的活产率较低相关（OR：0.53，95％CI：0.34-0.84，p=.008），流产率较高（40％vs.26.2%,p=.04）。
结论：我们表明，患有TS的女性怀孕，无论是OD还是自发受孕，有产科风险，因此,有TS的女人，考虑到怀孕,应接受全面的孕前咨询和最佳的产科护理。
方法：回顾性单中心横断面研究。
方法：74名患有TS的妇女接受了OD治疗，总共105次怀孕，31名TS女性有71个自发概念。生育结局包括临床妊娠和活产率。妊娠结局包括流产率，高血压患病率，妊娠期糖尿病,下段剖宫产术（LSCS），小于胎龄（SGA），TS的早产和垂直传播。
结果：在有TS的人中，与自发性妊娠相比，OD妊娠与LSCS和SGA的发生率增加相关；LSCS（OR：4.19，95％CI：1.6-10.8，p=.003）和SGA（OR：2.92，95％CI：1.02-8.38，p=.04）。没有记录的心脏事件，但发现了5例（17.2％）女儿中TS的垂直传播。与POI女性相比，TS患者的OD与每个周期开始的活产率较低相关（OR：0.53，95％CI：0.34-0.84，p=.008），流产率较高（40％vs.26.2%,p=.04）。
结论：我们表明，患有TS的女性怀孕，无论是OD还是自发受孕，有产科风险，因此,有TS的女人，考虑到怀孕,应接受全面的孕前咨询和最佳的产科护理。
