Fertility of Tall Girls Treated with High-Dose Estrogen, a Dose-Response Relationship

A. E. J. Hendriks*, S. L. S. Drop, J. S. E. Laven, A. M. Boot

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

28 Citations (Scopus)


Context: High-dose estrogen treatment to reduce final height of tall girls increases their risk for infertility in later life.

Objective: The aim was to study the effect of estrogen dose on fertility outcome of these women.

Design/Setting: We conducted a retrospective cohort study of university hospital patients.

Patients: We studied 125 tall women aged 20-42 yr, of whom 52 women had been treated with 100 mu g and 43 with 200 mu g of ethinyl estradiol (EE) in adolescence.

Main Outcomes: Time to first pregnancy, treatment for infertility, and live birth rate were measured.

Results: The time to first pregnancy was increased in treated women. Of untreated women, 80% conceived within 1 yr vs. 69% of women treated with 100 mu g EE and 59% of women treated with 200 mu g EE. This trend of increased time to pregnancy with increasing estrogen dose was significant (log rank trend test, P = 0.01). Compared with untreated women, fecundability was reduced in women treated with both 100 mu g EE [hazard ratio = 0.42; 95% confidence interval (CI), 0.19-0.95] and 200 mu g EE (hazard ratio = 0.30; 95% CI, 0.13-0.72). We also observed a significant trend in the incidence of treatment for infertility with increased estrogen dose (P = 0.04). Fecundity was affected in women treated with 200 mu g EE who had reduced odds of achieving at least one live birth (odds ratio = 0.13; 95% CI, 0.02-0.81), but not in women treated with 100 mu g EE.

Conclusions: We report a dose-response relationship between fertility in later life and estrogen dose used for the treatment of tall stature in adolescent girls; a higher estrogen dose is associated with increased infertility. (J Clin Endocrinol Metab 97: 3107-3114, 2012)

Original languageEnglish
Pages (from-to)3107-3114
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Issue number9
Publication statusPublished - Sep-2012



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