Fertility Issues in Disorders of Sex Development

GUERCIO, G; COSTANZO, M; GRINSPON, R.; REY, R.

ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA

W B SAUNDERS CO-ELSEVIER INC

Lugar: Philadelphia; Año: 2015 vol. 44 p. 867 - 881

0889-8529

Fertility potential should be considered by the multidisciplinary team when addressing gender assignment, surgical management, patient and family counseling of individuals with disorders of sex development (DSD). Fertility potential in these patients should be analyzed considering the severity of the condition and sex of rearing. In 46,XY individuals, defects of gonadal differentiation (dysgenetic DSD) or in androgen or anti-Müllerian hormone (AMH) synthesis or action result in incomplete or absent masculinization. In severe forms, raised as females, motherhood may be possible with oocyte donation provided Müllerian ducts have developed. In milder forms, raised as males, azoospermia or oligospermia are frequently found, however paternity has been reported. In 46,XX patients, virilization along with normal ovarian organogenesis is caused by excessive exposure to androgens of fetal or maternal origin; alternatively, ovotestes can be the source. Most patients are raised as females, and fertility might be possible after adequate hormonal and surgical treatments.