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Anogenital Distance and Endometriosis: Results of a Case–Control Study

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Abstract

AGD is the distance measured from the anus to the genital tubercle. Recent evidence suggests that a shorter AGD, a sensitive biomarker of the prenatal hormonal environment, could be associated with higher endometriosis risk. However, studies investigating AGD in affected women are scanty. We have set up a case–control study recruiting nulliparous women (aged 18–40 years) with endometriosis between 2017 and 2018. Cases were 90 women with a surgical or with a current nonsurgical diagnosis of endometriosis (n = 45 deep infiltrating endometriosis (DIE), and n = 45 ovarian endometrioma (OMA)). Controls were 45 asymptomatic women referring for periodical gynaecological care and without a previous diagnosis of endometriosis. They were matched to cases for age and BMI. For each woman, two measures were obtained using a digital calliper: AGDAC, from the clitoral surface to the upper verge of the anus, and AGDAF, from the posterior fourchette to the upper verge of the anus. Each distance was derived from the mean of six measurements acquired from two different gynaecologists. The mean ± SD AGDAC in women with DIE, OMA and without a diagnosis of endometriosis was 76.0 ± 12.1, 76.1 ± 11.1 and 77.8 ± 11.4 mm, respectively (p = 0.55). The mean ± SD AGDAF in women with DIE, OMA and without a diagnosis of endometriosis was 22.8 ± 5.0, 21.7 ± 9.0 and 23.7 ± 7.8 mm, respectively (p = 0.38). Our study failed to find an association between AGD and the presence of endometriosis. AGD does not seem to represent a reliable indicator of the presence of endometriosis to be used in clinical practice.

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Authors and Affiliations

  1. Gynaecology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Commenda, 12 - 20122, Milan, Italy

    Laura Buggio, Dhouha Dridi & Paolo Vercellini

  2. Department of Clinical Sciences and Community Health, Università Degli Studi Di Milano, Milan, Italy

    Edgardo Somigliana, Greta Sergenti, Federica Ottolini & Paolo Vercellini

  3. Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Edgardo Somigliana

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  1. Laura Buggio
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Contributions

L.B. contributed to the design of the study, recruitment of study participants, interpretation of the data and drafted the manuscript; P.V. and E.S. contributed to the design of the study and critical revision of the manuscript; F.O. and D.D. contributed to the recruitment of study participants; E.S, G.S. contributed to the analysis and interpretation of the data. All authors reviewed and approved the final version of the manuscript.

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Correspondence to Laura Buggio.

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Ethics Approval

The questionnaire and methodology for this study were approved by the local Institutional Review Board (Comitato di Etica Milano Area B). Ethics approval number: 261_2017bis.

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

Edgardo Somigliana reports personal fees from THERAMEX and MERCK-SERONO, and grants from FERRING and MERCK-SERONO. All the other authors declare that they have no conflicts of interest.

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Buggio, L., Somigliana, E., Sergenti, G. et al. Anogenital Distance and Endometriosis: Results of a Case–Control Study. Reprod. Sci. 29, 3508–3515 (2022). https://doi.org/10.1007/s43032-022-01009-7

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