OBJECTIVE To study whether markers of prenatal exposure to reproductive hormones are related to Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, polycystic ovary syndrome (PCOS), and endometriosis. DESIGN Case-control study. Comparison of sex hormone-related external genital and digital characteristics in cases and controls. SETTING University hospital. PATIENT(S) We enrolled 172 women in four groups-women with MKRH, women with PCOS, women with endometriosis, and controls (43 in each group). INTERVENTION(S) Measurement of two anthropometric biomarkers: anogenital distance and digit ratio. MAIN OUTCOME MEASURE(S) Anogenital distance was measured from the anus to the anterior clitoral surface (AGDac) and from the anus to the posterior fourchette (AGDaf). For the digit ratio we used a direct, as well as a computer-assisted graphic measurement to measure the length of the second and fourth digit. RESULT(S) After adjustment for body mass index and age, AGDac was the shortest in endometriosis and the longest in PCOS groups, with a mean difference of 10 mm (95% confidence interval 3.1-16.8). AGDaf but not AGDac measures were found to be significantly larger in the MRKH group, with a mean difference compared with controls of 2.6 mm (95% confidence interval 0.1-5.2). The digit ratio was not significantly different between the groups. CONCLUSION(S) In this study we did find limited evidence for androgen exposure during the development of MRKH. This is compatible with the hypothesis that the uterovaginal agenesis may have been the result of temporary prenatal exposure to altered gonadal hormone concentrations. For endometriosis and PCOS we confirm previously observed associations for anogenital distance reflecting possible estrogen-based and androgen-based intrauterine origins, respectively. DUTCH TRIAL REGISTRATION NUMBER NTR7492.

中文翻译：

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Mayer-Rokitanksy-Küster-Hauser 综合征、多囊卵巢综合征和子宫内膜异位症女性产前生殖激素暴露异常的人体测量学生物标志物

目的 研究产前生殖激素暴露标志物是否与 Mayer-Rokitansky-Küster-Hauser (MRKH) 综合征、多囊卵巢综合征 (PCOS) 和子宫内膜异位症有关。设计 病例对照研究。病例和对照中性激素相关外生殖器和手指特征的比较。设置大学医院。患者 我们在四个组中招募了 172 名女性——MKRH 女性、PCOS 女性、子宫内膜异位症女性和对照组（每组 43 名）。干预措施 两种人体测量生物标志物的测量：肛门生殖器距离和手指比例。主要结果测量（S） 从肛门到阴蒂前表面 (AGDac) 和从肛门到后阴道 (AGDaf) 测量肛门生殖器距离。对于数字比率，我们使用了直接的，以及计算机辅助图形测量来测量第二和第四位数字的长度。结果（S） 调整体重指数和年龄后，AGDac 在子宫内膜异位症中最短，在 PCOS 组中最长，平均差异为 10 mm（95% 置信区间 3.1-16.8）。发现 MRKH 组的 AGDaf 但不是 AGDac 测量值显着更大，与对照组相比平均差异为 2.6 mm（95% 置信区间 0.1-5.2）。各组之间的手指比例没有显着差异。结论在这项研究中，我们确实发现了 MRKH 发展过程中雄激素暴露的有限证据。这与子宫阴道发育不全可能是产前暂时暴露于性腺激素浓度改变的结果的假设相一致。对于子宫内膜异位症和 PCOS，我们证实了先前观察到的肛门生殖器距离关联，分别反映了可能的基于雌激素和基于雄激素的宫内起源。荷兰试验注册号 NTR7492。