TY - JOUR
T1 - Anthropometric biomarkers for abnormal prenatal reproductive hormone exposure in women with Mayer-Rokitanksy-Küster-Hauser syndrome, polycystic ovary syndrome, and endometriosis
AU - Peters, Henrike E.
AU - Laeven, Claire H.C.
AU - Trimbos, Constantia J.M.A.
AU - van de Ven, Peter M.
AU - Verhoeven, Marieke O.
AU - Schats, Roel
AU - Mijatovic, Velja
AU - Lambalk, Cornelis B.
PY - 2020/12
Y1 - 2020/12
N2 - Objective: To study whether markers of prenatal exposure to reproductive hormones are related to Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, polycystic ovary syndrome (PCOS), and endometriosis. Design: Case-control study. Comparison of sex hormone-related external genital and digital characteristics in cases and controls. Setting: University hospital. Patient(s): We enrolled 172 women in four groups—women with MKRH, women with PCOS, women with endometriosis, and controls (43 in each group). Intervention(s): Measurement of two anthropometric biomarkers: anogenital distance and digit ratio. Main Outcome Measure(s): Anogenital distance was measured from the anus to the anterior clitoral surface (AGDac) and from the anus to the posterior fourchette (AGDaf). For the digit ratio we used a direct, as well as a computer-assisted graphic measurement to measure the length of the second and fourth digit. Result(s): After adjustment for body mass index and age, AGDac was the shortest in endometriosis and the longest in PCOS groups, with a mean difference of 10 mm (95% confidence interval 3.1–16.8). AGDaf but not AGDac measures were found to be significantly larger in the MRKH group, with a mean difference compared with controls of 2.6 mm (95% confidence interval 0.1–5.2). The digit ratio was not significantly different between the groups. Conclusion(s): In this study we did find limited evidence for androgen exposure during the development of MRKH. This is compatible with the hypothesis that the uterovaginal agenesis may have been the result of temporary prenatal exposure to altered gonadal hormone concentrations. For endometriosis and PCOS we confirm previously observed associations for anogenital distance reflecting possible estrogen-based and androgen-based intrauterine origins, respectively. Dutch Trial Registration Number: NTR7492.
AB - Objective: To study whether markers of prenatal exposure to reproductive hormones are related to Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, polycystic ovary syndrome (PCOS), and endometriosis. Design: Case-control study. Comparison of sex hormone-related external genital and digital characteristics in cases and controls. Setting: University hospital. Patient(s): We enrolled 172 women in four groups—women with MKRH, women with PCOS, women with endometriosis, and controls (43 in each group). Intervention(s): Measurement of two anthropometric biomarkers: anogenital distance and digit ratio. Main Outcome Measure(s): Anogenital distance was measured from the anus to the anterior clitoral surface (AGDac) and from the anus to the posterior fourchette (AGDaf). For the digit ratio we used a direct, as well as a computer-assisted graphic measurement to measure the length of the second and fourth digit. Result(s): After adjustment for body mass index and age, AGDac was the shortest in endometriosis and the longest in PCOS groups, with a mean difference of 10 mm (95% confidence interval 3.1–16.8). AGDaf but not AGDac measures were found to be significantly larger in the MRKH group, with a mean difference compared with controls of 2.6 mm (95% confidence interval 0.1–5.2). The digit ratio was not significantly different between the groups. Conclusion(s): In this study we did find limited evidence for androgen exposure during the development of MRKH. This is compatible with the hypothesis that the uterovaginal agenesis may have been the result of temporary prenatal exposure to altered gonadal hormone concentrations. For endometriosis and PCOS we confirm previously observed associations for anogenital distance reflecting possible estrogen-based and androgen-based intrauterine origins, respectively. Dutch Trial Registration Number: NTR7492.
KW - Mayer-Rokitansky-Küster-Hauser syndrome
KW - anogenital distance
KW - digit ratio
KW - endometriosis
KW - polycystic ovary syndrome
UR - http://www.scopus.com/inward/record.url?scp=85092055993&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.fertnstert.2020.06.029
DO - https://doi.org/10.1016/j.fertnstert.2020.06.029
M3 - Article
C2 - 33036791
SN - 0015-0282
VL - 114
SP - 1297
EP - 1305
JO - Fertility and Sterility
JF - Fertility and Sterility
IS - 6
ER -