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Hum. Reprod. Advance Access published online on February 3, 2005
Human Reproduction, doi:10.1093/humrep/deh764
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Human Reproduction © European Society of Human Reproduction and Embryology 2005; all rights reserved
Received June 1, 2004
Revised December 19, 2004
Accepted January 7, 2005

Article

Uterine size in women with Turner syndrome after induction of puberty with estrogens and long-term growth hormone therapy: results of the German IGLU Follow-up Study 2001

Helmuth G. Doerr 1*, Markus Bettendorf 2, Berthold P. Hauffa 3, Otto Mehls 2, Carl-Joachim Partsch 4, Elfriede Said 5, Sabine Sander 5, Hans-Peter Schwarz 6, Nikolaus Stahnke 7, Heiner Steinkamp 5, Michael B. Ranke 8, and for the German IGLU Follow-up Study

1 University Hospital for Children and Adolescents, Erlangen, Germany
2 University Children's Hospital, Heidelberg, Germany
3 Department of Paediatric Haematology/Oncology and Endocrinology, University Children's Hospital, Essen, Germany
4 Paediatric Endocrinology, University Children's Hospital, Kiel, Germany
5 Pfizer Corporation, Karlsruhe, Germany
6 University Children's Hospital, Munich, Germany
7 University Children's Hospital, Hamburg, Germany
8 Paediatric Endocrinology Section, University Children's Hospital, Tübingen, Germany

* To whom correspondence should be addressed.
Helmuth G. Doerr, E-mail: hgdoerr{at}kinder.imed.uni-erlangen.de


  Abstract

BACKGROUND: To evaluate the factors influencing uterine size in young adult women with Turner syndrome (TS) after long-term growth hormone (GH) treatment. METHODS: Cross-sectional study. Out of 188 women with TS from 96 German centres, whose longitudinal growth was documented within KIGS (Pfizer International Growth Database), data on uterine size were collected voluntarily at a standardized follow-up visit: 75 TS women (ages: 15.8-30.8 years) with complete data were included. Classification according to karyotype: 45,X (78.6%), 45,X/46,XX (5.4%), 45,X/46,iXq (8%), 45,X/46,XY (8%). Puberty was induced with estrogens in all women. At follow-up, 66 were on cyclic estrogens and progestins. RESULTS: 13/66 (19.6%) TS women who received estrogens had a reduced uterine length <5 cm. Calculating the data in standard deviation scores (SDS), only women with 45,X/46,XX karyotype had normal median uterine length and volume of 0.6 and 1.59 SDS respectively. An incomplete breast development (Tanner stage B 3) was found in women with 45,X karyotype (n=11; 18.6%) and with 45,X/46,XY (n=2). CONCLUSIONS: Only TS women with karyotype 45,X/46,XX had normal uterine sizes, whereas 26% of the TS women with karyotype 45,X had a uterine length <-2 SDS, and 18% a volume <-2 SDS.

Keywords: estrogen therapy; gonadal dysgenesis; Turner syndrome; uterine size.
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