Live birth after allografting of ovarian cortex between monozygotic twins with Turner syndrome (45,XO/46,XX mosaicism) and discordant ovarian function.

Donnez, Jacques [UCL] Dolmans, Marie-Madeleine [UCL] Squifflet, Jean-Luc [UCL] Kerbrat, Guy [Hôpital de Parly II-Le Chesnay, france] Jadoul, Pascale [UCL]

OBJECTIVE: To report the restoration of ovarian function in a woman with Turner syndrome by allografting ovarian cortex from her monozygotic twin. DESIGN: Case report. SETTING: Gynecology research unit in a university hospital. PATIENT(S): A 37-year-old woman with Turner syndrome who had suffered premature ovarian failure (POF) at the age of 15. INTERVENTION(S): In this woman, we performed ovarian cortex transplantation. The donor was her monozygotic twin who had not experienced POF and who had had two normal deliveries. MAIN OUTCOME MEASURE(S): Restoration of ovarian activity and pregnancy. RESULT(S): Restoration of ovarian function was achieved 3 months after transplantation. After 7 months of regular cycles, spontaneous pregnancy occurred. The patient delivered a healthy baby girl weighing 2,850 g at 38 weeks of gestation. CONCLUSION(S): Girls with Turner syndrome suffer accelerated loss of ovarian follicles and only 2%-5% experience spontaneous menses with the potential to achieve pregnancy without medical intervention. This manuscript reports the first live birth after allografting between monozygotic twins with 45,XO/46,XX mosaicism and discordant growth pattern and ovarian function.