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Cited by 20Ovarian function and disordersSexual Differentiation and DisordersEffects and risks of endocrine disrupting chemicals

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Foetal Sonographic Anogenital Distance Is Longer in Polycystic Ovary Syndrome Mothers

Open access
Perlman, Sharon, Toledano, Yoel, Kivilevitch, Zvi, Halevy, Nufar, Rubin, Elena, Gilboa, Yinon·2020·Journal of Clinical Medicine
DOI 10.3390/jcm9092863PMC PMC7563834
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Abstract

Anogenital distance (AGD) is a biomarker for the prenatal hormonal environment. Androgen excess is a key element in polycystic ovary syndrome (PCOS). The aim of this study was to assess the sonographic foetal AGD in a population of PCOS mothers in comparison to the general population. Foetal AGD was measured prospectively by 2D ultrasound in PCOS mothers and compared to prenatal AGD nomograms. The results were interpreted regarding maternal and foetal characteristics. The mean sonographic foetal AGD centile measurement in PCOS mothers was significantly longer in comparison to the general population (86.04% ± 18.22; p < 0.001). Estimated foetal weight and birthweight were appropriate for gestational age and did not correlate with AGD. Sonographic foetal AGD was significantly longer in PCOS diabetic mothers and in those who conceived following assisted reproduction treatments when compared to the general population (p < 0.001). Our results support the role of AGD as a biomarker of the prenatal hormonal environment and provide evidence for the hyperandrogenic effect in PCOS pregnancies on foetal androgenic status and genitalia development.

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Figures

Figure 1 Sonographic landmarks for ano-genital distance measurement in male (a) and female (b) foetuses. In an axial view, at the level of the foetal perineum, the ano-genital distance is measured from the foetal anus to the base of the scrotum in the male or to the posterior commissure of the labia in females.
Figure 1 Sonographic landmarks for ano-genital distance measurement in male (a) and female (b) foetuses. In an axial view, at the level of the foetal perineum, the ano-genital distance is measured from the foetal anus to the base of the scrotum in the male or to the posterior commissure of the labia in females.CC BY · PubMed Central
Figure 2 The ano-genital distance in PCOS mothers: male foetuses. The red marks represent the distribution of the measurements over the 2.5–97.5th centiles for local normal reference range. The green line represents the 50th centile [22].
Figure 2 The ano-genital distance in PCOS mothers: male foetuses. The red marks represent the distribution of the measurements over the 2.5–97.5th centiles for local normal reference range. The green line represents the 50th centile [22].CC BY · PubMed Central
Figure 3 The ano-genital distance in PCOS mothers: female foetuses. The red marks represent the distribution of the measurements scattered over the 2.5–97.5th centiles for local normal reference range. The green line represents the 50th centile [22].
Figure 3 The ano-genital distance in PCOS mothers: female foetuses. The red marks represent the distribution of the measurements scattered over the 2.5–97.5th centiles for local normal reference range. The green line represents the 50th centile [22].CC BY · PubMed Central
Figure 4 (a). Ano-genital distance measurements obtained in a PCOS-mothers’ female foetus at 28 weeks of gestation. The foetal anogenital distance correlates with the 97.5th percentile for gestational age [22]. (b). Three-dimensional surface render of the perineal region demonstrating mild clitoromegaly that could also be attributed to exposure to an intra-uterine increased level of androgens. Post-natal examination revealed normal genitalia with no evidence of virilization.
Figure 4 (a). Ano-genital distance measurements obtained in a PCOS-mothers’ female foetus at 28 weeks of gestation. The foetal anogenital distance correlates with the 97.5th percentile for gestational age [22]. (b). Three-dimensional surface render of the perineal region demonstrating mild clitoromegaly that could also be attributed to exposure to an intra-uterine increased level of androgens. Post-natal examination revealed normal genitalia with no evidence of virilization.CC BY · PubMed Central

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Metadata

Authors
Perlman, S., Toledano, Y., Kivilevitch, Z., Halevy, N., Rubin, E., & Gilboa, Y.
Affiliations
  • Tel Aviv University (IL)
  • Rabin Medical Center (IL)
Corresponding author
Perlman, Sharon
ORCID
Venue
Journal of Clinical Medicine
Publisher
MDPI AG
Published
2020-09-04
Volume
9
Issue
9
Pages
2863
ISSN
2077-0383 (ISSN-L)
DOI
10.3390/jcm9092863
PMC
PMC7563834
OpenAlex
W3083354441
Cited by
20
References
46
Citations by year
2026: 2 · 2025: 1 · 2024: 6 · 2023: 3 · 2022: 4 · 2021: 4
FWCI
2.43
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Clinical Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Sexual Differentiation and Disorders
  • Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
Keywords
polycystic ovary syndrome, anogenital distance, hyperandrogenism, prenatal biomarkers, assisted reproduction, maternal diabetes, birth weight

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CoChat. (2026). Citation check: Foetal Sonographic Anogenital Distance Is Longer in Polycystic Ovary Syndrome Mothers. https://app.cochat.ai/papers/10.3390/jcm9092863
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Perlman, S., Toledano, Y., Kivilevitch, Z., Halevy, N., Rubin, E., & Gilboa, Y. (2020). Foetal Sonographic Anogenital Distance Is Longer in Polycystic Ovary Syndrome Mothers. Journal of Clinical Medicine. https://doi.org/10.3390/jcm9092863