Introduction:
Most women with TS are infertile due to octype loss that starts during embryonic life. Spontaneous pregancies are seen in 2-5% of TS patients and are most likely to occur in woman with the mosaic from TS. Since some girls with TS have pollicles in their ovaies before puberty, one of the options to preserve their fertility is cryopreservation of either ovarian cortical tissue or of oocytes. Cryopreservation of the former is exsperimental while the latter can only involve a limited number of oocytes and is difficult to perform if the patient is a virgo intacta, even through recent survival rates of vitrified mature oocytes have reached 86% per thawed oocytes (McGill Reproductive Center - unpublished data, 2006). Moreover, the applicability of such new techniques to preserve fertility with autologous oocytes in TS patients might be compromised by a high rate of aneuploid gametes and congenital malformations. The high frequency of miscarriage reported in spontaneus pregnancies women with TS and chromosomal aberrations which are more common in children born must be taken into account when counseling such women.

The successful use of donated oocytes has brought a new hope to TS patients, and pregnancy rates equal those of other infertile women. Because there is a tremendous shortage of oocytes donors worldwide, cuoples, often search for a donor amoung family members. This is generally ethically acceptable; but second-degree relatives such a cousins, nephews, aunts or uncles are considered more acceptable than first-degree. International oocytes donation has generally been problematic because of obvious age differences. We report the first attemp of mother-to-daughter donation ina young girl with Turner's syndrome.

Material and methods:
A 33-year-old multigravida healthy woman with 3 children and normal karyotype presented with her second child, a 6-year-old daughter, who had been diagnosed with TS [46, X, l(X), (q10)]. Her other two children have a normal karyotype.
After considering the option of fertility preservation for her daughter, including the poor outcome of pregnancy from oocytes of women with TS, the woman decided against cryopreservation of ovarian tissue or oocytes.
Because the mother was young and very fertile, she decided to create an oocytes bank for the daughter by serial IVF egg vitrification. The Hospital Research Ethics Board (REB) approved this treatment and written consent forms were obtained.

Result:
The woman underwent 2 cycles of long-protocol ovarian stimulation for IVF tratment with mature oocytes collection and vitrification. In the first cycle, 12 MII-stage oocytes were retrieved and vitrified; while in the second cycle, 10 oocytes were retrieved, 9 of which were MII stage, and vitrified. One oocytes remained at GV stage even after 24 hours.
After two cycles we vitrified a total of 21 oocytes.

Conclusion:
Many concerns have been raised about intragenerational and intergenerational gamete donation. Intergenerational oocytes donationn is particularly controversial because of the potential for coercion. In this case, the mother is freezing oocytes out of concern fot her daughter's future welfare, and the daughter and her future partner have a choice as to whether to use these eggs or not. This opens the door to the use of oocyte verification by mother to daughter in other medical conditions that lead to premature ovarian failure and subsequently infertility.

Fonte: Abstracts of the 23rd Annual Meeting of the ESHRE, Lyon