Extreme virilization in patients with congenital adrenal hyperplasia fails to induce descent of the ovary

Scheffer, Ingrid E.; Hutson, John M.; Warne, Garry L.; Ennis, G. C.

doi:10.1007/bf00182774

Cited by 9 publications

(2 citation statements)

References 20 publications

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“…3B). This is in contrast with the lack of a similar observation in other androgen-exposed females (Hamilton and Wolfe, 1938;Scheffer et al, 1988;van der Schoot and Elger, 1992). These mice were noted to be more than 70 U below the lower pole of the kidney, similar to the finding by Hutson (1987) that the usual position of the testis, using a similar method of calculation, is 80 U for the right and 70 U for the left.…”

Section: Discussioncontrasting

confidence: 73%

“…In addition, rats exposed to prenatal flutamide have also been noted to be frequently descended to the inguinal region, and were found to have retained cranial ligaments (Shono et al, 1994a). In the syndrome of congenital adrenal hyperplasia (CAH), in which very high levels of endogenous androgens in genetic females cause severe virilisation and androgen-induced regression of the cranial suspensory ligament, ovaries were reported to be in their normal positions (Scheffer et al, 1988;Scott, 1987). These findings are opposed to that of van der Schoot's and question the validity of his arguments, appearing to relegate the cranial suspensory ligament to an insignificant role in testicular descent.…”

Section: Discussionmentioning

confidence: 97%

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Effect of androgens on the cranial suspensory ligament and ovarian position

Lee

Hutson

1999

Anat. Rec.

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Androgens have been postulated to have a major role in testicular descent via regression of the cranial suspensory ligament, which in normal rodents anchors the ovary to the retroperitoneum near the lower pole of the kidney. This study aimed to quantitate the degree of descent of the foetal ovary in androgen-treated female mice to determine the role of androgens in regression of the cranial suspensory ligament and descent of the testis. Time-pregnant mice were injected with testosterone propionate or methyl testosterone (2.5-3.0 mg) in vehicle on day 13 or 14. Control animals received vehicle only. Newborn mice were anaesthetised and dissected for macroscopic anatomy of the ovary, which was quantified by measuring the vertical distance from the lower pole of the kidney to the lower pole of the ovary. Histological analysis was also performed. The external genitalia were masculinised in all females exposed to prenatal androgens. The ovaries of treated animals were mobile, with no cranial suspensory ligament, and located slightly caudal to the kidney. Wolffian duct structures were identifiable, but the gubernaculum was qualitatively unchanged compared with control females. The ovary was displaced caudally (P< 0.001), but only 15-25% of the distance to the lower abdomen. Exogenous androgens induce regression of the cranial suspensory ligament, causing the ovary to be more mobile and lower in the abdominal cavity. However, since the testicular position at birth is at or below the bladder neck, androgen-mediated regression of the cranial suspensory ligament is only an adjunct to the control of transabdominal testicular descent.

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Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 97%

Effect of androgens on the cranial suspensory ligament and ovarian position

Lee

Hutson

1999

Anat. Rec.

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Disorders of Sex Development

Crouch¹,

Creighton²

2014

Jones’ Clinical Paediatric Surgery

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The birth of a new baby is one of the most dramatic events in a family, and the first question is usually "is it a boy or a girl?" The newborn infant with ambiguous external genitalia often comes as a surprise for the doctors as well as the parents and is sometimes described as an endocrine emergency situation presenting a problem of sex assignment. The nomenclature such as 'intersex', 'hermaphrodite', and 'pseudohermaphrodite' is out of date as well as confusing, and many urologists are concerned that these confusing terms could be perceived to be pejorative by some affected families. In response to concerns regarding outdated and controversial terms, the Chicago Consensus held in 2005 recommended new terminology based on the umbrella term disorders of sex differentiation (DSDs). The term DSD has a comprehensive definition including any problem noted at birth in which the genitalia are atypical in relation to the chromosomes or gonads. The karyotype is used as a prefix defining the classification of DSD. DSDs are rare and complex. The optimal management of patients with DSD must be individualized and multidisciplinary, considering all aspects, including psychological care and full disclosure of alternatives relating to surgery type and timing. Although further studies are necessary to confirm guidelines and recommendations fitting for the individual patients with DSD, this article is an attempt to provide a balanced perspective for new taxonomy, clinical evaluation, and medical, surgical, and psychological management of DSD.

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DSD Later in Childhood

Hutson

Warne

2011

Disorders of Sex Development

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Extreme virilization in patients with congenital adrenal hyperplasia fails to induce descent of the ovary

Cited by 9 publications

References 20 publications

Effect of androgens on the cranial suspensory ligament and ovarian position

Effect of androgens on the cranial suspensory ligament and ovarian position

Disorders of Sex Development

DSD Later in Childhood

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