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Objectives <p>To evaluate whether anogenital distance (AGD) can serve as a surrogate marker for polycystic ovarian syndrome (PCOS) and to assess its association with different PCOS phenotypes.</p> Study Design <p>Prospective case–control study.</p> Methods <p>Nulliparous women ≥ 18&#xa0;years attending a tertiary gynaecology clinic were enrolled. Cases were diagnosed with PCOS using Rotterdam criteria, and controls had regular menstrual cycles without clinical hyperandrogenism. Women with endocrine or androgen-excess disorders and prior perineal surgery were excluded. AGD from anus to clitoris (AGDac) and anus to posterior fourchette (AGDaf) was measured using a calibrated stainless-steel digital calliper. Three readings were averaged and analysed.</p> Results <p>A total of 110 participants were included (55 PCOS, 55 controls). AGDaf (31.28 ± 6.25&#xa0;mm vs 31.38 ± 4.62&#xa0;mm; mean difference − 0.10&#xa0;mm; 95%CI − 2.15 to 1.96; <i>p</i> = 0.93; d =  − 0.02), AGDac (78.44 ± 8.58mm vs 76.77 ± 7.87&#xa0;mm; mean difference 1.67&#xa0;mm; 95%CI − 1.41 to 4.75; <i>p</i> = 0.29; d = 0.20) and AGD ratio (2.58 ± 0.50 vs 2.49 ± 0.39; mean difference 0.09; 95%CI − 0.08 to 0.26; <i>p</i> = 0.28; d = 0.21) did not differ significantly between groups. In adjusted logistic regression (for BMI and age), none of the AGD parameters were independently associated with PCOS (adjusted OR 0.97–1.96; all <i>p</i> &gt; 0.18). ROC AUC values ranged from 0.53 to 0.69. Phenotype distribution was A(25%), B(6%), C(4%) and D(65%), with no AGD differences among phenotypes.</p> Conclusion <p>In this Indian cohort, AGD was not significantly associated with PCOS and demonstrated limited diagnostic value. Small effect sizes and poor AUC values suggest AGD is unlikely to serve as a surrogate marker for PCOS.</p>

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Association of Anogenital Distance with Polycystic Ovarian Syndrome

  • 期刊论文

  • 发表日期：

    2026年5月27日

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  • Monisha Ravi,
  • Ranjana Puleria,
  • Sarita Singh,
  • Achla Batra,
  • Abhishek Lachyan

摘要

Objectives

To evaluate whether anogenital distance (AGD) can serve as a surrogate marker for polycystic ovarian syndrome (PCOS) and to assess its association with different PCOS phenotypes.

Study Design

Prospective case–control study.

Methods

Nulliparous women ≥ 18 years attending a tertiary gynaecology clinic were enrolled. Cases were diagnosed with PCOS using Rotterdam criteria, and controls had regular menstrual cycles without clinical hyperandrogenism. Women with endocrine or androgen-excess disorders and prior perineal surgery were excluded. AGD from anus to clitoris (AGDac) and anus to posterior fourchette (AGDaf) was measured using a calibrated stainless-steel digital calliper. Three readings were averaged and analysed.

Results

A total of 110 participants were included (55 PCOS, 55 controls). AGDaf (31.28 ± 6.25 mm vs 31.38 ± 4.62 mm; mean difference − 0.10 mm; 95%CI − 2.15 to 1.96; p = 0.93; d =  − 0.02), AGDac (78.44 ± 8.58mm vs 76.77 ± 7.87 mm; mean difference 1.67 mm; 95%CI − 1.41 to 4.75; p = 0.29; d = 0.20) and AGD ratio (2.58 ± 0.50 vs 2.49 ± 0.39; mean difference 0.09; 95%CI − 0.08 to 0.26; p = 0.28; d = 0.21) did not differ significantly between groups. In adjusted logistic regression (for BMI and age), none of the AGD parameters were independently associated with PCOS (adjusted OR 0.97–1.96; all p > 0.18). ROC AUC values ranged from 0.53 to 0.69. Phenotype distribution was A(25%), B(6%), C(4%) and D(65%), with no AGD differences among phenotypes.

Conclusion

In this Indian cohort, AGD was not significantly associated with PCOS and demonstrated limited diagnostic value. Small effect sizes and poor AUC values suggest AGD is unlikely to serve as a surrogate marker for PCOS.