Patients with Turner's syndrome may have an inherent endometrial abnormality affecting receptivity in oocyte donation

Objective: To evaluate whether endometrial receptivity is compromised in patients with premature ovarian failure (POF) due to Turner's syndrome who undergo oocyte donation. Design: Retrospective analysis. Setting: In vitro fertilization-ET units, anonymous oocyte donation program. Patients: The study included 53 patients with POF who underwent oocyte donation. These included 7 patients with Turner's syndrome (45,X) who underwent 22 ET cycles, 15 women with Turner variants (mosaics, deletions, or isochromosomes) who underwent 36 ET cycles, and 31 other patients with POF and a normal karyotype who underwent 69 oocyte donation cycles. Intervention: All patients on standby for donation were treated with E(2) valerate 6 mg/d until oocytes became available; then P 100 mg/d was added. Oocyte donors were healthy women <34 years who underwent IVF themselves. Main Outcome Measures: Clinical pregnancy rates (PRs), biochemical pregnancies, early abortions, and delivery rates were evaluated. Results: Turner's syndrome patients had a significantly higher rate of biochemical pregnancies (22.7% versus 4.3%), a lower clinical PR (22.7% versus 33.3%), a significantly higher rate of early abortions (60% versus 8.7%), and a significantly lower rate of deliveries per pregnancy (20.0% versus 73.1%) compared with non-Turner patients. Conclusions: Patients with a complete or partial deficiency of an X chromosome have reduced PRs and an increase in early implantation failure after oocyte donation. This may indicate an inherent endometrial abnormality, possibly associated with a deficiency of X-linked genes regulating endometrial receptivity.