Hum. Reprod. Advance Access originally published online on December 15, 2006
Human Reproduction 2007 22(3):895-900; doi:10.1093/humrep/del451
GnRH agonist treatment in girls with precocious puberty does not compromise post-pubertal uterine size
1 Helen Schneider Hospital for Women, Rabin Medical Center, Beilinson Campus 2 Epilepsy Center 3 Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva Israel 4 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
5 To whom correspondence should be addressed at: Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, 14 Kaplan Street, Petah Tikva 49202, Israel. Tel: +972 3 925 3282; Fax: +972 3 925 3836; E-mail: liatd{at}clalit.org.il
BACKGROUND: Prompted by findings of a hypoestrogenic state in girls during prolonged treatment with GnRH agonist and a close association of estradiol serum concentrations with uterine volume in puberty, this study sought to evaluate uterine and ovarian size in girls with precocious puberty (PP) during and after treatment and the effect of age or duration of treatment.
METHODS: Patients with idiopathic central PP before (n = 75), during (n = 41) or after (n = 30) treatment with GnRH agonist underwent transabdominal pelvic ultrasound examination. Findings were compared with those in 69 girls with epilepsy and no PP before initiation of anticonvulsant treatment.
RESULTS: The girls with PP had significantly greater uterine and ovarian volumes before, during and after treatment with GnRH agonist than the controls, after adjusting for age at examination, weight, height and pubic and breast status. The average interval between the last treatment and the ultrasound examination was 1.3 years. There was no significant correlation between age at first treatment and uterine volume after treatment. Uterine volume decreased during treatment. There was a significant negative correlation between treatment duration and uterine volume after treatment (R2 = –0.175, P = 0.024). Nevertheless, mean uterine volume was still greater in the treated group than in the control group (P = 0.002).
CONCLUSION: The iatrogenic hypoestrogenic state in treated girls with PP does not compromise post-pubertal uterine size.
Key words: GnRH agonist/precocious puberty/uterine size
Submitted on July 16, 2006; resubmitted on October 16, 2006; accepted on October 20, 2006.