Zusammenfassung
Frauen mit Turner-Syndrom haben eine prämature Ovarialinsuffizienz. Folglich ist ihre Fertilität in den meisten Fällen stark eingeschränkt. Bei Kinderwunsch kommen neben einer selten eintretenden spontanen Schwangerschaft die Verfahren der künstlichen Befruchtung infrage. Biologisch möglich ist die Verwendung autologer (soweit verfügbar) und heterologer Gameten. Der Einsatz heterologer Gameten (Eizellspende, gespendetes Ovargewebe, gespendete Embryonen, Leihmutterschaft) ist in Deutschland verboten. Patientinnen mit Turner-Syndrom haben schwangerschaftsbedingt ein erheblich gesteigertes Morbiditäts- und Mortalitätsrisiko. Insbesondere besteht ein erhöhtes kardiovaskuläres Risiko mit drohender Aortendissektion. Die relative Kontraindikation gegen eine Schwangerschaft aufgrund des erhöhten Risikos ist gegen die subjektiv empfundene Belastung der Kinderlosigkeit abzuwägen. In bestimmten kardiovaskulären Konstellationen ist eine Schwangerschaft absolut kontraindiziert.
Abstract
Women with Turner syndrome comprise a premature ovarian failure. Subsequently their fertility is reduced. For those wishing to conceive a rare spontaneous conception is possible as well as the use of artificial reproductive technology (ART). The utilisation of autologous (if available) and heterologous gametes is biologically feasible. The application of heterologous gametes (oocyte donation, donated ovarian tissue, donated embryos, surrogacy) is not permissible in Germany. Patients with Turner syndrome have a considerably increased morbidity and mortality in pregnancy compared to healthy women. Most importantly they are at elevated cardiovascular risk and are threatened by aortic dissection. The relative contraindication for pregnancy due to increased risk must be balanced against the subjectively perceived challenge of infertility. Certain cardiovascular constellations signify an absolute contraindication for pregnancy.
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Interessenkonflikt. B. Rösing gibt an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Rösing, B. Fertilitätstherapie beim Turner-Syndrom. Gynäkologische Endokrinologie 12, 103–112 (2014). https://doi.org/10.1007/s10304-013-0616-9
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DOI: https://doi.org/10.1007/s10304-013-0616-9