Algorithmic approach to decision-making for fertility preservation in girls and women with Turner syndrome

A proposed algorithmic approach to decision-making for fertility preservation in females diagnosed with Turner syndrome. For prepubertal girls with sufficient ovarian reserve, expert experience dictates utility of serial serum AMH assessments to delay intervention to a postpubertal age, so that oocyte cryopreservation can be considered. Serum AMH level of ≤2 ng/mL corresponds to levels in the lower quartile for girls 5 to 13 years of age^[1]. In postpubertal girls, because the risk of follicle loss is extremely high and can proceed at a fast pace, we recommend fertility preservation regardless of the initial AMH.