Magnetic resonance imaging of Müllerian duct anomalies in children

MRI is widely considered the best modality for assessing Müllerian duct anomalies

Abstract

Müllerian duct anomalies encompass a wide variety of disorders resulting from abnormalities in the embryological development of the Müllerian ducts. In the prepubertal pediatric population, Müllerian duct anomalies are often incidental findings on studies obtained for other reasons. The onset of menses can prompt more clinical symptoms. Proper characterization of Müllerian duct anomalies is important because these anomalies can affect the development of gynecological disorders as well as fertility. Müllerian duct anomalies also carry a high association with other congenital anomalies, particularly renal abnormalities.

National Institutes of Health, NCBI PubMed PMID: 27229498, 2016 May.

Magnetic resonance imaging (MRI) is widely considered the best modality for assessing Müllerian duct anomalies; it provides multiplanar capability, clear anatomical detail and tissue characterization without ionizing radiation. MRI allows for careful description of Müllerian duct anomalies, often leading to classification into the most widely accepted classification system for Müllerian duct anomalies. This system, developed by the American Society of Reproductive Medicine, includes seven subtypes:

  1. uterine agenesis/hypoplasia,
  2. unicornuate,
  3. didelphys,
  4. bicornuate,
  5. septate,
  6. arcuate,
  7. and diethylstilbestrol (DES) drug-related uterus.

In cases of complex anomalies that defy classification, MRI allows detailed depiction of all components of the anatomical abnormality, allowing for proper management and surgical planning.

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The estrogen effect : how chemical pollution is threatening our survival

Altering Eden : the feminization of nature, by Deborah Cadbury

Altering Eden : the feminization of nature, by Deborah Cadbury.

The Book was first published January 1st 1997 under the original title: “Altering Eden : the feminization of nature”.

With the world population now exceeding six billion, it may seem strange that scientists are worried about threats to human fertility. Yet dramatic decreases in human sperm counts (a 50% decline since the 1940s) and soaring rates of testicular cancer suggest that there is cause for concern.

Science journalist Deborah Cadbury, here expanding her Emmy-winning Horizon program “Assault on the Male,” presents evidence that the widespread use of synthetic chemicals has disrupted our and other animals’ natural hormonal systems, in effect flooding them with megadoses of estrogen-like substances that “feminize” males and contribute to breast cancer and myriad other problems.

The list of suspect chemicals is alarming: DES, DDT, PCBs, plastics (used in everything from washing machines to dental sealants and food packaging), even birth-control pills. Traces of these substances have been detected in soil, water, wildlife and humans from around the globe, and have been implicated in such conditions as animal hermaphroditism, impaired sperm quality, microphallus, prostate cancer, endometriosis and even impaired intelligence.

How researchers began to recognize the problem and piece together its clues is a compelling and frightening story, which Cadbury tells with journalistic verve. Though she admits that a definite causal relationship between chemical exposure and reproductive abnormalities has not yet been proven, she finds the evidence compelling. This is a chilling account of industrialization’s adverse – and perhaps irreversible – effects.

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Prenatal female hormone administration and psychosexual development in human males

Human personality is associated with prenatal hormone exposure

Abstract

ScienceDirect Psychoneuroendocrinology, doi:10.1016/0306-4530(80)90032-3, Volume 5, Issue 4, 1980, Pages 269–285 and Popline Document Number: 001953, node/460051, 1980 Dec.

Male personality by Meghana Kulkarni.

  • Considerable data exist from animal research relating prenatal hormone levels to postnatal behaviors in the male. The data from human males are few. One strategy for testing this association is the study of humans exposed prenatally to exogenous ‘pregnancy maintaining hormones’.
  • A follow-up study was conducted on 62 adult males prenatally exposed to exogenous sex hormones. Fifty-eight young adult males exposed to one of four hormone regimens were matched against nonhormone exposed controls. There were 17 males exposed to diethylstilbestrol (DES), 22 exposed to DES and natural progesterone, 10 to natural progesterone only, and 13 to synthetic progesterone.
  • Subjects were interviewed – to ascertain their psychosexual development during boyhood and adolescence and sexual functioning during adolescence and adulthood – and administered the Bem Sex-Role Inventory (BSRI), the Guilford-Zimmerman Temperament Survey (GZTS), the Strong Vocational Interest Blank (SVIB), and the Embedded Figures Test (EFT).
  • The specific drug, total dosage, and time of drug administration i.e., the trimester of exposure, were significantly associated with several aspects of boyhood, adolescent, and adult psychosexual development on interview and with differences in scales of the psychometric tests.
  • The behavior of subjects exposed to each substance was compared to the control behavior and to behavior of those exposed to other substances. The femininity scale was elevated for 3 of the 4 drug regimens but not for the natural progesterone group.
  • The most contrasting boyhood behaviors were between those exposed to progesterone and DES. Progesterone subjects tended to recall boyhood behaviors which departed from the conventional male mode toward ‘femininity’. The DES subjects tended to recall the most conventionally ‘masculine’ boyhoods. During adulthood, DES plus natural progesterone subjects reported a high sex drive while synthetic progesterone subjects reported a low sex drive. Erectile failure was more often reported by subjects exposed to natural progesterone only.
  • Three drug regimens were associated with elevations of the Feminine scale of the BSRI and two with elevations of the feminine scale of the GZTS.
  • The rates of homosexual behavior were comparable for drug and non-drug-exposed subjects.
  • The study illustrates that human personality is associated with prenatal hormone exposure.
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