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

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 (haz 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)