Homologous in vitro fertilization in Turner syndrome: insights from a case report

Objective: To describe a bigeminal pregnancy obtained with a homologous intracytoplasmic sperm injection cycle in a patient with high-grade mosaic Turner syndrome (45, XO/47,XXX 97.5%/2.5%) with bicuspid aortic valve. Design: Case report. Setting: Unit of Pathophysiology of Human Reproduction in a general hospital. Patient(s): Patient with mosaic Turner syndrome with bicuspid aortic valve. Intervention(s): Homologous intracytoplasmic sperm injection cycle after controlled ovarian hyperstimulation with a GnRH agonist flare-up depot protocol and menotropins. Main Outcome Measure(s): Pregnancy development, echocardiographic monitoring of aortic root, karyotypes of progeny. Result(s): Ongoing bigeminal pregnancy with the delivery of two healthy infants (46, XX and 46, XY, respectively) by cesarean section without any cardiovascular complication or aortic root echocardiographic modification in the mother. Conclusion(s): Even in patients with Turner syndrome with high-grade 45, XO mosaicism and reduced ovarian reserve, a trial of homologous reproduction should be offered after a thorough cardiologic evaluation to avoid pregnancy-related cardiovascular complications. (Fertil Steril (R) 2009;91:1294.e1-e4. (C) 2009 by American Society for Reproductive Medicine.)