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Foetal Sonographic Anogenital Distance Is Longer in Polycystic Ovary Syndrome Mothers
Open accessAbstract
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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![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].](/paper-figures/497523f3d965489fae99fe5a79e66c51/foetal-sonographic-anogenital-distance-is-longer-in-polycystic-ovary-syndrome-figure-2.jpg)
![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].](/paper-figures/cc9f9b0688134e36bb4824027e60880c/foetal-sonographic-anogenital-distance-is-longer-in-polycystic-ovary-syndrome-figure-3.jpg)
![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.](/paper-figures/c6d2411f5b5340c180e5761fe42343ed/foetal-sonographic-anogenital-distance-is-longer-in-polycystic-ovary-syndrome-figure-4.jpg)
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“Daughters of mothers with PCOS also demonstrate evidence of longer AGDs than daughters of unaffected women (Barrett et al., 2018; Perlman et al., 2020, but see Glintborg et al., 2019), in association with high serum testosterone in affected mothers during gestation.”
From Endometriosis and polycystic ovary syndrome are diametric disorders (2021) · cites this paper as Perlman et al., 2020
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Cited by
Sorted by citations
Harada, M. (2022) · Reproductive Medicine and Biology · doi:10.1002/rmb2.12487 · Cited by 150
Endometriosis and polycystic ovary syndrome are diametric disorders
Dinsdale, N. L., & Crespi, B. J. (2021) · Evolutionary Applications · doi:10.1111/eva.13244 · Cited by 90
“Daughters of mothers with PCOS also demonstrate evidence of longer AGDs than daughters of unaffected women (Barrett et al., 2018; Perlman et al., 2020, but see Glintborg et al., 2019), in association with high serum testosterone in affected mothers during gestation.”
BackgroundDevelopmental Programming of Fertility in Cattle—Is It a Cause for Concern?
Wathes, D. C. (2022) · Animals · doi:10.3390/ani12192654 · Cited by 47
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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
- Venue
- Journal of Clinical Medicine
- Publisher
- MDPI AG
- Published
- 2020-09-04
- Volume
- 9
- Issue
- 9
- Pages
- 2863
- ISSN
- 2077-0383 (ISSN-L)
- 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
- gold
- doi.org
- 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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