Uterine Development After Estrogen Replacement Therapy in Women with Different Etiologies of Primary Hypogonadism

Kim, Hyo Jeong; Lee, Dong−Yun; Yoon, Byung-Koo; Choi, DooSeok

doi:10.1016/j.jpag.2015.11.011

Cited by 12 publications

(6 citation statements)

References 34 publications

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“…The effect of RT on uterine function was evaluated separately for nulligravidous and gravidous women, because uterine volume increases permanently after each pregnancy (18). Logistic regression models were used to estimate odds ratios (ORs) for having a small uterine volume after exposure to uterine RT, with adjustment for E 2 level and age at study inclusion as continuous variables, because both have been shown to affect uterine volume (19,20). For gravidous women, ORs were additionally adjusted for the duration (in weeks) of the women's longest pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Uterine function, pregnancy complications, and pregnancy outcomes among female childhood cancer survivors

Loo

Berg

Overbeek

et al. 2019

Fertility and Sterility

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Objective: To evaluate whether abdominal-pelvic radiotherapy for childhood cancer impairs uterine function and increases the risk of pregnancy complications and adverse pregnancy outcomes. Design: Nested cohort study. Setting: Not applicable. Patient(s): Childhood cancer survivors previously exposed to abdominal-pelvic radiotherapy (RT-exposed CCSs) as part of their treatment for childhood cancer. Intervention(s): Radiotherapy-exposed CCSs (n ¼ 55) were age-and parity-matched to nonirradiated CCSs (non-RT-exposed CCSs; n ¼ 110) and general population controls (n ¼ 110). Main Outcome Measures: Uterine volume, pregnancy complications, and pregnancy outcomes. Result(s): Among nulligravidous participants, median (interquartile range) uterine volume was 41.4 (18.6-52.8) mL for RT-exposed CCSs, 48.1 (35.7-61.8) mL for non-RT-exposed CCSs, and 61.3 (49.1-75.5) mL for general population controls. Radiotherapyexposed CCSs were at increased risk of a reduced uterine volume (<44.3 mL) compared with population controls (odds ratio [OR] 5.31 [95% confidence interval 1.98-14.23]). Surprisingly, the same was true for non-RT-exposed CCSs ). Among gravidous participants, RT-exposed CCSs had increased risks of pregnancy complications, preterm delivery, and a low birth weight infant compared with population controls ], respectively). Compared with non-RT-exposed CCSs, RT-exposed CCSs were at increased risk of delivering a low birth weight infant ).

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Section: Discussionmentioning

confidence: 99%

Uterine function, pregnancy complications, and pregnancy outcomes among female childhood cancer survivors

Loo

Berg

Overbeek

et al. 2019

Fertility and Sterility

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“…For uterine length, 65 mm is commonly used for maturity, [14][15][16] which is based on the normative data by Griffin et al 17 The ratio of fundus to cervix (FCR) is also described and some use an amalgamation of both to describe the uterus as immature, transitional or mature. There is variation in the literature as to the criteria comprising uterine maturity.…”

Section: Discussionmentioning

confidence: 99%

“…There is variation in the literature as to the criteria comprising uterine maturity. For uterine length, 65 mm is commonly used for maturity, [14][15][16] which is based on the normative data by Griffin et al 17 The ratio of fundus to cervix (FCR) is also described and some use an amalgamation of both to describe the uterus as immature, transitional or mature. 14,15,18,19 28.7 (6.8-73.5) TA B L E 2 Uterine size parameters comparing different oestrogen preparations used for induction of puberty (median and 5th and 95th centiles) size cannot be subsequently rectified and 'catch up' is not possible.…”

Section: Discussionmentioning

confidence: 99%

Reduced uterine volume after induction of puberty in women with hypogonadism

Burt

Davies

Yasmin

et al. 2019

Clinical Endocrinology

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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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“…HT induced significant increases in uterine volume and endometrial thickness in women with POI (O'Donnell et al, 2012;Kim et al, 2016;Kraus et al, 2018). Uterine volume increased regardless of estrogen type or route.…”

Section: Summary Of Resultsmentioning

confidence: 99%

“…In this phase we excluded 31 reports for several reasons and remained with 31 studies included in the review (Figure 1). The included studies comprised 15 articles reporting on 13 RCTs (Li et al, 1992;Lyritis et al, 1995;Kung et al, 1999;Fatemi et al, 2007;Langrish et al, 2009;Zuckerman-Levin et al, 2009;Crofton et al, 2010;Ross et al, 2011;O'Donnell et al, 2012;Guerrieri et al, 2014;Popat et al, 2014;Shah et al, 2014;Shea et al, 2015;Cartwright et al, 2016;Kraus et al, 2018) and 16 cohort studies (Emans et al, 1990;Achiron et al, 1995;Biljan et al, 1995;Castelo-Branco et al, 1996;Hartmann et al, 1997;Gökmen and Yapar Eyi, 1999;Khastgir et al, 2003;Kalantaridou et al, 2004;Chatterjee et al, 2011;Naessén et al, 2014;Benetti-Pinto et al, 2015;Nakamura et al, 2015;Kim et al, 2016;Vermeulen et al, 2017;Yang et al, 2017;Gazarra et al, 2020).…”

Section: Literature Search Resultsmentioning

confidence: 99%

Hormone therapy in women with premature ovarian insufficiency: a systematic review and meta-analysis

Gonçalves

Vasconcellos

Rodrigues

et al. 2022

Reproductive BioMedicine Online

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Uterine Development After Estrogen Replacement Therapy in Women with Different Etiologies of Primary Hypogonadism

Cited by 12 publications

References 34 publications

Uterine function, pregnancy complications, and pregnancy outcomes among female childhood cancer survivors

Uterine function, pregnancy complications, and pregnancy outcomes among female childhood cancer survivors

Reduced uterine volume after induction of puberty in women with hypogonadism

Hormone therapy in women with premature ovarian insufficiency: a systematic review and meta-analysis

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