24-years-old came for fertility consultation. She is obese (75 Kgs), Primary Amenorrhoea, Karyotype 46XX/47XXX (50%/50%) and streak ovaries on laparoscopy. She has almost all features of triple X syndrome. FSH 76, LH 25, AMH 0.6 (low fertility), estradiol 36pg/ml (Premenopausal range). she bleeds on withdrawal with MPA or Ovral-L.
Someone has advised her IVF-ET.
My question is that can she be tried for IVF with so high FSH and does she need physiological sex steroid replacement till 45 years of age (even when she has fair amount of estrogen production)?
She is a POF with no doubt, any thing other than HRT is wasting of time.
When you karyotyped her what tissue did you use? blood, I presume. It could be useful to determine the extent of her mosaicism -is it also in ectoderm? Karyotypng from a fibroblast biopsy may be useful or even FISH on hair follicles.
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