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Cited by 25Hypothalamic control of reproductive hormonesSexual Differentiation and DisordersGenetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities

Reduced uterine volume after induction of puberty in women with hypogonadism

Burt, Elizabeth, Davies, Melanie C., Yasmin, Ephia, Cameron‐Pimblett, Antoinette, Mavrelos, Dimitri, Talaulikar, Vikram, Conway, Gerard S.·2019·Clinical Endocrinology
DOI 10.1111/cen.14092
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Abstract

OBJECTIVE: Adequate uterine growth is an essential component of pubertal induction with exogenous oestradiol in those with hypogonadism. Poor uterine development will render the individual vulnerable in the context of fertility. We assessed uterine size using ultrasound in those who had undergone pubertal induction treatment compared with a reference group who had experienced spontaneous puberty. DESIGN: This is a single-centre, retrospective, cross-sectional study of women who underwent pubertal induction compared with a reference group. PATIENTS: Ninety-five women with hypogonadism who had previously undergone pubertal induction and were receiving maintenance oestrogen replacement as adults were recruited: 48 women with Turner syndrome, 32 with premature ovarian insufficiency and 15 with gonadotrophin deficiency. The reference group consisted of 35 nulliparous women attending with male factor subfertility with a normal pelvis on ultrasonography. MEASUREMENTS: Pelvic ultrasound was performed by a single observer. Uterine dimensions (total length, anterior-posterior (AP), transverse, uterine volume and fundal cervical AP ratio (FCR) measurements) were recorded. Clinical details were also recorded. RESULTS: Those with hypogonadism had significantly reduced uterine dimensions compared with the reference group (uterine length 64 mm vs 71 mm P = <.05, uterine volume 28.9 mL vs 43.9 mL P = <.05). All women in the reference group attained a mature uterine configuration with a FCR >1, compared with 84% of those with hypogonadism (P = .01). A total of 24% and 48% of the diagnostic group had total uterine length and uterine volume measurements less than the 5th percentile of the reference group, respectively. In a subgroup of 22 women in whom serum oestradiol concentrations could be analysed, there was a positive correlation between this parameter and uterine volume. CONCLUSION: Despite standard oestrogen therapy, uterine growth is often compromised in those with hypogonadism. Uterine health has historically been overlooked in pubertal induction protocols; however, with increasing options for fertility treatment, adequate uterine development is crucial. Given the variation in uterine size witnessed, a more tailored approach to treatment with regular monitoring of uterine dimensions should be advocated.

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Crossref · 10.1111/cen.14092

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  • Many young women with Turner syndrome benefit from a higher dose of estrogen than their older peers, exceeding 2 mg E2 orally or 50 mcg transdermally.

    “Many young women with TS benefit from a higher dose of estrogen than their older peers, that is, exceeding 2 mg E2 orally or 50 mcg TD.”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [302]

  • Higher estrogen doses are particularly important for achieving maximal uterine growth and development as options for fertility treatment increase.

    “This is particularly important for achieving maximal uterine growth and development as options for fertility treatment increase.”

    From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [302]

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Authors
Burt, E., Davies, M. C., Yasmin, E., Cameron‐Pimblett, A., Mavrelos, D., Talaulikar, V., & Conway, G. S.
Affiliations
University College London (GB)
Corresponding author
Burt, Elizabeth
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2019-10-09
Volume
91
Issue
6
Pages
798-804
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/cen.14092
OpenAlex
W2972234051
Cited by
25
References
22
Citations by year
2026: 1 · 2025: 1 · 2024: 9 · 2023: 4 · 2022: 3 · 2021: 5 · 2020: 2
FWCI
2.39
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
Keywords
uterine volume, puberty induction, hypogonadism, Turner syndrome, premature ovarian insufficiency, gonadotropin deficiency, estradiol, uterine growth, fertility, estrogen replacement therapy
MeSH terms
Adolescent, Adult, Cross-Sectional Studies, Female, Humans, Hypogonadism, Puberty, Retrospective Studies, Sexual Maturation, Turner Syndrome, Uterus, Young Adult

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