Pelvic ultrasound evaluation in patients with Turner syndrome during treatment with growth hormone.
OBJECTIVE
Treatment with growth hormone (GH), alone or in combination with oxandrolone, is used in patients affected by Turner syndrome to improve growth velocity and adult height. Since GH interacts with gonadotropins in the stimulation of the human ovary, the aim of our study was to evaluate the possible effects of GH administration on uterine and ovarian characteristics.


METHODS
We performed pelvic ultrasound assessment in 29 patients with Turner syndrome aged 7.5-16.6 years (19 with 45,X karyotype; 10 with variant karyotypes) before and during treatment with GH alone. Uterine volume and ovarian size and morphology were compared to those of 23 age-matched girls with Turner syndrome not treated with GH. Both patients and controls were divided into prepubertal and pubertal groups. Cross-sectional and longitudinal studies (before and every 6 months during GH treatment for 2 years) were performed.


RESULTS
We observed a significantly higher uterine anteroposterior diameter and volume in younger (< or = 11 years) GH-treated Turner syndrome girls than in those who were untreated. Also visualization and heterogeneous echopattern of the ovaries were significantly more frequent in treated than in untreated Turner syndrome patients, particularly before the age of 11 years. The longitudinal study showed a significant increase in uterine volume, more related to treatment than to age. Spontaneous breast development and menarche were found more frequently in GH-treated Turner syndrome girls.


CONCLUSIONS
Growth hormone therapy can have a co-gonadotropin role in patients with Turner syndrome.
Sampaolo
P
P
Department of Obstetrics and Gynecology, IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy. pasampag@tin.it
Calcaterra
V
V
Klersy
C
C
Alfei
A
A
De Leonardis
C
C
Maino
M
M
Larizza
D
D
D000293:Adolescent; D000886:Anthropometry; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D019382:Human Growth Hormone / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D008137:Longitudinal Studies; D008572:Menarche; D010053:Ovary / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D014424:Turner Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology
D019382:Human Growth Hormone