A E J Hendriks1, S L S Drop, J S E Laven, A M Boot. 1. Department of Pediatrics, Division of Endocrinology, Erasmus Medical Center-Sophia, Room Sp3435, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands. a.e.j.hendriks@erasmusmc.nl
Abstract
CONTEXT: High-dose estrogen treatment to reduce final height of tall girls increases their risk for infertility in later life. OBJECTIVE: The aim was to study the effect of estrogen dose on fertility outcome of these women. DESIGN/ SETTING: We conducted a retrospective cohort study of university hospital patients. PATIENTS: We studied 125 tall women aged 20-42 yr, of whom 52 women had been treated with 100 μg and 43 with 200 μg of ethinyl estradiol (EE) in adolescence. MAIN OUTCOMES: Time to first pregnancy, treatment for infertility, and live birth rate were measured. RESULTS: The time to first pregnancy was increased in treated women. Of untreated women, 80% conceived within 1 yr vs. 69% of women treated with 100 μg EE and 59% of women treated with 200 μg EE. This trend of increased time to pregnancy with increasing estrogen dose was significant (log rank trend test, P = 0.01). Compared with untreated women, fecundability was reduced in women treated with both 100 μg EE [hazard ratio = 0.42; 95% confidence interval (CI), 0.19-0.95] and 200 μg EE (hazard ratio = 0.30; 95% CI, 0.13-0.72). We also observed a significant trend in the incidence of treatment for infertility with increased estrogen dose (P = 0.04). Fecundity was affected in women treated with 200 μg EE who had reduced odds of achieving at least one live birth (odds ratio = 0.13; 95% CI, 0.02-0.81), but not in women treated with 100 μg EE. CONCLUSIONS: We report a dose-response relationship between fertility in later life and estrogen dose used for the treatment of tall stature in adolescent girls; a higher estrogen dose is associated with increased infertility.
CONTEXT: High-dose estrogen treatment to reduce final height of tall girls increases their risk for infertility in later life. OBJECTIVE: The aim was to study the effect of estrogen dose on fertility outcome of these women. DESIGN/ SETTING: We conducted a retrospective cohort study of university hospital patients. PATIENTS: We studied 125 tall women aged 20-42 yr, of whom 52 women had been treated with 100 μg and 43 with 200 μg of ethinyl estradiol (EE) in adolescence. MAIN OUTCOMES: Time to first pregnancy, treatment for infertility, and live birth rate were measured. RESULTS: The time to first pregnancy was increased in treated women. Of untreated women, 80% conceived within 1 yr vs. 69% of women treated with 100 μg EE and 59% of women treated with 200 μg EE. This trend of increased time to pregnancy with increasing estrogen dose was significant (log rank trend test, P = 0.01). Compared with untreated women, fecundability was reduced in women treated with both 100 μg EE [hazard ratio = 0.42; 95% confidence interval (CI), 0.19-0.95] and 200 μg EE (hazard ratio = 0.30; 95% CI, 0.13-0.72). We also observed a significant trend in the incidence of treatment for infertility with increased estrogen dose (P = 0.04). Fecundity was affected in women treated with 200 μg EE who had reduced odds of achieving at least one live birth (odds ratio = 0.13; 95% CI, 0.02-0.81), but not in women treated with 100 μg EE. CONCLUSIONS: We report a dose-response relationship between fertility in later life and estrogen dose used for the treatment of tall stature in adolescent girls; a higher estrogen dose is associated with increased infertility.
Authors: Fan Liu; A Emile J Hendriks; Arwin Ralf; Annemieke M Boot; Emelie Benyi; Lars Sävendahl; Ben A Oostra; Cornelia van Duijn; Albert Hofman; Fernando Rivadeneira; André G Uitterlinden; Stenvert L S Drop; Manfred Kayser Journal: Hum Genet Date: 2013-11-20 Impact factor: 4.132
Authors: E Kohva; T Varimo; H Huopio; S Tenhola; R Voutilainen; J Toppari; P J Miettinen; K Vaaralahti; J Viinamäki; J T Backman; M Hero; T Raivio Journal: Hum Reprod Date: 2020-02-29 Impact factor: 6.918