Pregnancies in women with Turner Syndrome: how do we counsel our patients?
Article In Press
Richard J. Paulson, M.D., M.S.
In this issue of Fertility and Sterility, the Fertile Battle debate focuses on the question of how best to counsel patients with Turner Syndrome (TS) regarding their options for pregnancy. Most patients with TS experience ovarian failure prior to menarche, but with egg donation, they can successfully conceive and carry the pregnancy to term, albeit with significantly increased obstetrical risks. The question is, are these risks so high that gestational surrogacy should routinely be advised? Are the risks so high that embryo transfer to the uterus of a TS patient should not even be considered? Are there screening methods that might divide the potential population into those individuals whose underlying cardiovascular risks are too high to allow pregnancy and those who might reasonably be monitored and guided by a skilled perinatologist through a high-risk pregnancy?