CONTEXT Most individuals with Turner syndrome (TS) require estrogen for pubertal induction. Current estrogen dosing guidelines are based on expert consensus opinion. OBJECTIVE Evaluate if current international guidelines for estrogen dosing during pubertal induction of individuals with TS result in normal uterine growth. We hypothesized that uterine size in individuals with TS who reached adult estrogen dosing is smaller than in mature females without TS. DESIGN Cross-sectional study. SETTING Patients with TS at the Cincinnati Center for Pediatric and Adult Turner Syndrome Care. PARTICIPANTS 29 individuals (age, 15-26 years) with primary ovarian insufficiency who reached adult estrogen dosing (100 mcg transdermal or 2 mg oral 17β-estradiol). Comparison of uterine measurements with a published sample of 292 age-appropriate (age, 15-20 years) controls without TS. INTERVENTIONS none. MAIN OUTCOME MEASURES Uterine length, volume, and fundal-cervical ratio (FCR) were measured. Clinical information (karyotype, Tanner staging for breast development, laboratory data) was extracted from an existing institutional patient registry. RESULTS There was no evidence of compromise of the uterine size/configuration in the TS cohort compared with the controls; in fact, uterine length- mean 7.7 cm (+/-1.3) vs. 7.2 cm (+/-1.0) (p = 0.03) and volume- mean 60.6 cm3 (+/-26.6) vs. 50.5 cm3 (+/-20.5) (p = 0.02), were both larger in TS individuals. CONCLUSION Current international guidelines for hormone replacement using 17β-estradiol in TS individuals appear adequate to allow for normal uterine growth by the end of pubertal induction.

中文翻译：

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目前推荐的特纳综合征青春期诱导雌激素剂量可导致正常子宫生长。

背景 大多数特纳综合征 (TS) 患者需要雌激素来诱导青春期。目前的雌激素剂量指南基于专家共识。目的 评估当前关于 TS 患者青春期诱导期间雌激素剂量的国际指南是否会导致正常子宫生长。我们假设达到成人雌激素剂量的 TS 个体的子宫尺寸小于未患 TS 的成熟女性。设计横断面研究。设置 辛辛那提儿童和成人特纳综合征护理中心的 TS 患者。参与者 29 名原发性卵巢功能不全患者（年龄 15-26 岁）达到成人雌激素剂量（100 微克透皮给药或 2 毫克口服 17β-雌二醇）。将子宫测量值与已发表的 292 名不带 TS 的适龄（年龄，15-20 岁）对照样本进行比较。干预措施 无。主要观察指标 测量子宫长度、体积和宫底-宫颈比（FCR）。临床信息（核型、乳房发育的坦纳分期、实验室数据）是从现有的机构患者登记处提取的。结果 与对照组相比，没有证据表明 TS 队列的子宫大小/结构有所改变；事实上，子宫长度 - 平均 7.7 厘米 (+/-1.3) 与 7.2 厘米 (+/-1.0) (p = 0.03) 和体积 - 平均 60.6 厘米 (+/-26.6) 与 50.5 厘米 (+/-) 20.5) (p = 0.02)，在 TS 个体中都更大。结论 目前关于 TS 个体使用 17β-雌二醇进行激素替代的国际指南似乎足以在青春期诱导结束时使子宫正常生长。