Anogenital distance is related to ovarian follicular number in young Spanish women: a cross-sectional study

Abstract

BackgroundIn animals, anogenital distance (AGD) at birth reflects androgen levels during pregnancy and predicts adult AGD. Little is known about AGD in relation to female reproductive characteristics in humans, a question this study was designed to explore.MethodsWe used multiple linear and logistic regression analyses to model the relationships between adult female reproductive system characteristics (e.g. ovarian morphology, menstrual cycle) and two measures of AGD [anus-fourchette (AGDAF) and anus-clitoris (AGDAC)] in 100 college-age volunteers in Spain. Ovarian morphology was classified as having < 6 or ≥ 6 follicles per ovary.ResultsBoth AGD measures were positively associated with ovarian follicle number, with AGDAF being more strongly associated. Women in the upper tertile of the AGDAF and AGDAC distributions were more likely to have ≥ 6 ovarian follicles [OR: 6.0 (95% CI 2.0, 17.6) and 3.0 (95% CI 1.1, 8.6), respectively] compared to women in the lowest tertile.ConclusionsIncreased follicular recruitment has been related to excess androgen exposure in utero in toxicological studies. Our results suggest that the androgenic environment during early fetal life may influence reproductive system development, including AGD, in human females.

Prenatal exposure to perfluoroalkyl substances and anogenital distance at 3 months of age in a Danish mother-child cohort

“…AGD in males may be used as a marker of testicular dysgenesis syndrome (TDS), which suggests that the increased incidence of reproductive problems such as hypospadias, cryptorchidism, testis cancer and poor semen quality are symptoms of a shared underlying fetal testicular dysgenesis resulting from a disturbance in the Sertoli cell and Leydig cell differentiation during fetal life, leading to impaired testosterone production and decreased virilization. Less is known about AGD in females and their reproductive system characteristics (Mendiola et al, 2012). However, a study found positive associations between AGD and follicular number in women (Mendiola et al, 2012).…”

Ano-genital distance in healthy Nigerian full-term newborn infants

“…In humans, AGD tracks from birth to early childhood and therefore, measurements at birth may be linked to later reproductive disorder (5, 6). In a report from the international panel of experts suggests that AGD is an important clinical measure to address endocrine-sensitive endpoints in the first year of life and recommended more in-depth examination of the congenital adrenal hyperplasia (9) and multi-follicular ovaries (10). All these, reflect the usefulness of AGD measurements in both males and females.…”

“…Maintaining a newborn in the measurement position without moving, while the measurements are made, is difficult (10). In order to overcome this problem, several anthropometric protocols have been developed for the measurement of AGD.…”

“…Although AGD measurements sound straightforward, determining the actual measurement that needs to be taken and taking accurate measurements are 2 difficult tasks (10). Maintaining a newborn in the measurement position without moving, while the measurements are made, is difficult (10).…”

Re: Longer anogenital distance is associated with higher testosterone levels in women: a cross‐sectional study

“…A good example is the 5-year follow-up of the largest randomised trial of repeat ACS courses: multiple courses of antenatal corticosteroids study at 5 years of age (MACS-5). 4 At the level of the entire cohort, compared with a single course of ACS, multiple courses of ACS were not associated with any detrimental effects that could be attributed to the treatment. In a post-hoc exploratory analysis comparing the treatment effect in term versus preterm infants, however, those born at term had a four-fold increased odds ratio for neurosensory disability, and this relationship was present even when the total number of ACS courses did not exceed two.…”