46,XY gonadal dysgenesis: three case reports demonstrating an evolution in management

Treatment of phenotypic females with XY gonadal dysgenesis is evolving. In the past, these patients have routinely undergone hysterectomy with bilateral gonadectomy. Since the major concern in women with XY gonadal dysgenesis is ovarian malignancy, these patients need not only gonadectomy but frozen section and appropriate surgical staging based on histologic findings. However, even women with stage I dysgerminoma do not require hysterectomy. The state of the art in reproductive endocrinology makes it possible for us not only to offer them the development of secondary sexual characteristics with cyclic replacement therapy, but also the opportunity for childbearing with the use of embryo transfer.