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Cited by 118Assisted Reproductive Technology and Twin PregnancyReproductive Health and TechnologiesGenetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities

Obstetric and neonatal outcome after oocyte donation in 106 women with Turner syndrome: a Nordic cohort study

Hagman, A., Loft, A., Wennerholm, U.-B., Pinborg, A., Bergh, C., Aittomaki, K., Nygren, K.-G., Bente Romundstad, L. +2 more·2013·Human Reproduction
DOI 10.1093/humrep/det082
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Abstract

STUDY QUESTION: What are the obstetric and neonatal outcomes of deliveries after oocyte donation (OD) in women with Turner syndrome (TS)? SUMMARY ANSWER: Pregnancies among women with TS carry a substantial risk, particularly for hypertensive disorders. Potentially life-threatening complications occurred in 3.3% of pregnancies. The neonatal outcomes were generally reassuring, with similar rates of preterm birth and low birthweight (LBW) as after conventional IVF and better than previously reported in deliveries after OD in women with TS. WHAT IS KNOWN ALREADY: OD pregnancies in women with TS are known to be high-risk pregnancies. STUDY DESIGN, SIZE, DURATION: This retrospective cohort study included 106 women with TS who delivered after OD (n = 122 deliveries, n = 131 newborns) in three Nordic countries (Finland, Denmark, Sweden) between 1992 and 2011. PARTICIPANTS, SETTING AND METHODS: Women with TS who delivered after OD in three Nordic countries were identified (n = 110). Four women declined to participate or were lost to follow-up, thus 106 women were included in the study. The medical data from fertility clinics, antenatal clinics and the hospitals where the women had been treated and/or delivered were scrutinized. MAIN RESULTS AND THE ROLE OF CHANCE: In this cohort, the karyotype was 45,X in 44% of the women with TS. Ten women (9.4%) had a known cardiac defect before pregnancy. Single embryo transfer was performed in 70.3% of the cases and the multiple birth rate was 7.4%. In total, 35.0% of the pregnancies were associated with a hypertensive disorder including pre-eclampsia in 20.5%. Potentially life-threatening complications occurred in four pregnancies (3.3%), including one woman with aortic dissection, one with mild regurgitation of the tricuspid and mitral valve, one with a mechanical heart valve who developed HELLP syndrome (haemolysis, elevated liver enzymes, low platelets) and one who underwent a post-partum hysterectomy due to severe haemorrhaging. Neonatal outcomes were reassuring, with a preterm birth rate of 8.0% and LBW rate of 8.8% in singletons. Major birth defects were found in 3.8% of the children. The perinatal mortality was 2.3% (3/131), including a set of extremely preterm twins. LIMITATIONS, REASONS FOR CAUTION: Although this study was performed over a period of almost 20 years in three different countries, with a low drop-out rate and little missing data, much larger series are needed to assess rare events. This study also lacks an appropriate control group. WIDER IMPLICATIONS OF THE FINDINGS: This study suggests that cardiovascular evaluation before and during pregnancy may contribute to favourable obstetric outcomes in many cases. Maternal outcomes were in agreement with the literature while neonatal outcomes were generally better than previously reported. The outcomes were consistent across the three countries, supporting generalizability to similar populations.

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Crossref · 10.1093/humrep/det082

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  • Women with TS are at increased risk for hypertensive disorders of pregnancy, including pre-eclampsia.

    “Women with TS are at increased risk for hypertensive disorders of pregnancy, including pre-eclampsia.522-524”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [524]

  • Pregnancies in individuals with TS are associated with a higher risk of maternal and fetal complications, as are pregnancies after oocyte donation in both TS and non-TS individuals.

    “Pregnancies in individuals with TS are associated with a higher risk of maternal and fetal complications as are pregnancies after oocyte donation in both TS and non-TS individuals.511,524,586”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [524]

  • Pregnancy complications are more common after oocyte donation compared to autologous IVF or spontaneous pregnancies in individuals with TS.

    “Pregnancy complications are more common after oocyte donation compared to autologous IVF or spontaneous pregnancies.524”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [524]

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Authors
Hagman, A., Loft, A., Wennerholm, U.-B., Pinborg, A., Bergh, C., Aittomaki, K., Nygren, K.-G., Bente Romundstad, L., Hazekamp, J., & Soderstrom-Anttila, V.
Affiliations
  • Sahlgrenska University Hospital (SE)
  • Copenhagen University Hospital (DK)
  • Karolinska Institutet (SE)
Corresponding author
Hagman, A.
ORCID
Venue
Human Reproduction
Publisher
Oxford University Press (OUP)
Published
2013-03-27
Volume
28
Issue
6
Pages
1598-1609
ISSN
  • 0268-1161 (ISSN-L)
  • 1460-2350
DOI
10.1093/humrep/det082
OpenAlex
W2143884410
Cited by
118
References
51
Citations by year
2026: 3 · 2025: 7 · 2024: 9 · 2023: 5 · 2022: 9 · 2021: 8 · 2020: 17 · 2019: 8 · 2018: 7 · 2017: 8 · 2016: 14 · 2015: 13 · 2014: 7 · 2013: 3
FWCI
11.44
Type
journal article
Language
en
Open access
closed
Locations
  • Human Reproduction (publishedVersion)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Funders
  • Stiftelsen Handlanden Hjalmar Svenssons
  • Göteborgs Läkaresällskap
  • Sahlgrenska Universitetssjukhuset
  • Nordic Pharma Group
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Assisted Reproductive Technology and Twin Pregnancy
  • Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
Keywords
Turner syndrome, oocyte donation, pregnancy outcomes, hypertensive disorders of pregnancy, preeclampsia, aortic dissection, HELLP syndrome, perinatal mortality, preterm birth, low birth weight, congenital heart disease, major birth defects, single embryo transfer, multiple pregnancy, maternal complications, neonatal outcomes, 45,X
MeSH terms
Adult, Denmark, Embryo Transfer, Female, Fertilization in Vitro, Finland, Humans, Pregnancy, Pregnancy Outcome, Retrospective Studies, Sweden, Turner Syndrome, Oocyte Donation, Karyotype

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