Reproductive Services Unit, The Royal Women's Hospital, Parkville VIC 3052, Australia.
Department of Obstetrics and Gynaecology, University of Melbourne, The Royal Women's Hospital, Parkville, VIC 3052, Australia.
Best Pract Res Clin Endocrinol Metab. 2019 Jun;33(3):101289. doi: 10.1016/j.beem.2019.101289. Epub 2019 Jul 9.
Disorders of sex development (DSD) are a group of complex conditions that can affect chromosomal, gonadal, and/or phenotypical sex with a highly variable fertility potential amongst affected individuals. In this review we discuss fertility issues facing patients affected by DSD and Turner syndrome and summarise the literature on fertility and reproductive outcomes. We will also discuss fertility preservation prior to gonadotoxic treatment in adolescent and prepubertal girls. Future directions in fertility preservation and ethical issues will also be addressed. Fertility preserving options that are established include ovarian tissue and oocyte cryopreservation. However, in many of the DSDs fertility is not possible and the discussion may need to move toward alternative methods of creating a family such as gamete donation or surrogacy.
性发育障碍(DSD)是一组复杂的疾病,可影响染色体、性腺和/或表型性别,受影响个体的生育能力具有高度可变性。在这篇综述中,我们讨论了患有 DSD 和特纳综合征的患者面临的生育问题,并总结了关于生育和生殖结果的文献。我们还将讨论青春期前和青春期前女孩在性腺毒性治疗前进行生育力保存的问题。还将讨论生育力保存的未来方向和伦理问题。已确立的生育力保存选择包括卵巢组织和卵母细胞冷冻保存。然而,在许多 DSD 中,生育是不可能的,因此讨论可能需要转向创造家庭的替代方法,如配子捐赠或代孕。