Abstract
Primary amenorrhoea (PA) is one of the common reproductive disorder affecting females.PA is characterised by the absence of menarche in the reproductive age group in females and some cases with absence of reproductive organs. The study was carried out in large cohort (N=490) of subjects with PA to identify genetic, anatomical and hormonal factors responsible for PA. Conventional cytogenetic and FISH (fluorescence in situ hybridization) technique were applied to detect the chromosomal abnormalities. The chromosomal abnormalities were detected in total 121 (24.7%) females. In our cohort numerical chromosomal aberrations frequency was found to be high (43.8%) as compared to structural abnormalities (26.4%). The 46, XY karyotype was identified in 29.8% patients. The anatomical abnormalities including absences of ovaries (51.2%), streak ovaries (35.6%), hypoplastic uterus (59.6%), absent uterus (22.3%) were also detected and correlated with genetic abnormalities in this cohort. FSH (follicular stimulating hormone) level were also found to be high in these patients. Our study suggests that genetic investigation are important for further management of the disease.
Keywords: Primary amenorrhea, Cytogenetics, Chromosomal abnormalities, Karyotype, Secondary Sexual Characters, Follicular stimulating hormone (FSH), Ultrasonography (USG).
References
- Speroff L, Fritz MA, eds. Amenorrhea. Clinical gynaecologic endocrinology and infertility, 7th edn. Philadelphia: Lippincott Williams, 2005, p.401-464.
- Sayee Rajangam, Leelavathy Nanjappa et.al. Cytogenetic studies in amenorrhea. Soudi Med J 2007; 28(2): 187-192
- Catherine j Hayden. Primary amenorrhea: Investigation and treatment. Obstetrics, gynaecology and reproductive medicine 17.7,2007 Elsevier Ltd.: 199-204
- Wong MS, Lam ST. Cytogenetic analysis of patients with Primary and Secondary Amenorrhea in Hong Kong: Retrospective study. Hong Kong Med J 2005; 11(4): 267-272.
- S.Moorhead, P.C.Nowell, W.J.Mellman, D.M. Battips, D.A. Hungerford. Chromosome preparations of leukocytes cultured from human peripheral blood. Experimental cell research1960; 20: 613-616.
- Seabright M: A rapid banding technique for human chromosomes. Lancet1971; 2:97
- McGowan-Jordan J, Simons A, Schmid M (eds) (2016) An international system for human cytogenomic nomenclature. S. Karger, Basel. [Reprint of Cytogenet Genome Res 149(1–2)]
- Van Niekerk WA. Chromosomes and the Gynaecologist. Am J ObstetGynecol1978; 130(8):291-292.
- Ten SK, Chin YM, Noor PJ, Hasan K. Cytogenetic studies in women with primary amenorrhea. Singapore Med J 1990; 31(4):355-359.
- Roy AK, Banerjee D. Cytogenetic study of primary amenorrhea. J Indian Med Assoc 1995; 93(8):291-292.
- Temocin K, Vardar MA, Suleymanova D, OzerE, Tanriverdi N, Demirhan O et al. Results of cytogenetic investigation in adolescent patients with primary or secondary amenorrhea. J PediatrAdolescGynecol1997; 10(2):86-88.
- Lakshimi Kalpana V, Satyanarayana M. Cytogenetic Analysis of Primary Amenorrhea Cases. Ind J Hum Genet 1997; 3 (2):81-91.
- Mondel SK, Guha D, Banerjee D, Sinha SK. Study of primary amenorrhea with special reference to cytogenetic evaluation. Indian J Pathol Microbiol 2002; 45(2):155-9.
- Cortes-Gutierrez El, Davila Rodriguez MI, Vargas-Villarreal J, Cerda- Flores RM. Prevalence of chromosomal aberrations in Mexican women with primary amenorrhea.Reprod Biomed Online. 2007; 15(4):463-7.
- Hariharan S, Sheeja VR, Santhi S, Vani S, Sreeja L, Ankathil R. Chromosome analysis in patients with primary amenorrhea. Proc. 19th Sci. Congress, 331-332, 2007
- Vijayalakshmi J, Koshy T, Kaur H, Andrea F, Selvi R, Deepa Parvathi et. al.Cytogenetic Analysis of Patients with Primary Amenorrhea. Int J Hum Genet 2010; 10(1-3):71-76.
- Rizwan N,Abbasi RM. Primary Amenorrhea and the Outcome of Treatment at Liaquat University Hospital. JLUMHS, May-August 2008; 110-114.
- Safaei A, Vasei M, Hossein A H.Cytogenetic Analysis of Patients with Primary Amenorrhea in Southwest of Iran. Iranian Journal of Pathology 2010; 5(3):121-125.
- Tanmahasamut P, Rattanachaiyanont M, Dangrat C, Indhavivadhana S, Angsuwattana S. Causes of primary amenorrhea: a report of 295 cases in Thailand. J ObstetGynaecol Res 2012; 38 (1): 297-301.
- Faeza El Dahtory. Chromosomal abnormalities and hormonal disorders of primary amenorrhea patients in Egypt. Indian J Human Genetics.2012 May-Aug;18(2):183-186
- Merin T, Rema D, Preetha T, Amuda S et al. Amenorrhoea: Cytogenetic Studies and Beyond. Am J Mol Cellu Biol.2012;1:25-32
- Amin SV, Rai L, Palpandi P, Kumaran A. Ever intriguing ‘Primary Amenorrhea’- an audit. Int J Reprod Contracept Obstet Gynecol.2014; 3(4): 1090-1096.
- Joseph A, Thomas I M. Cytogenetic investigations in 150 cases with complaints of sterility or primary amenorrhea. Human Genetics. 1982; 61(2): 105-109.
- Paliwal P, Sharma A, Birla S, Kriplani A, et al. Identification of novel SRY mutations and SF1 (NR5A1) changes in patients with pure gonadal dysgenesis and 46,XY karyotype. Molecular Human Reproduction 2011; 17: 372-378.
- Manuel M, Katayama PK, Jones HW, Jr. The age of occurrence of gonadal tumors in intersex patients with a Y chromosome. Am J ObstetGynecol1976; 124:293-300.
- NazM, Khanum S, Niaz A, Fatima U. Frequency of Disturbance of Hormonal Profile (LH to FSH Ratio) In Girls of Age Group 14-18 Years with Primary Amenorrhea. JUMDC 2013; 4: 30-35.
- Kara N, Tural S, Elbistan M, Karakus N et al. Cytogenetic Findings of Patients with Amenorrhea in Turkish Population. Int J Hum Genet 2012; 12(2): 87-92.
Corresponding Author
Dr Babu Rao Vundinti
Department of Cytogenetics, National Institute of Immunohaematology (ICMR),
13th floor, New Multistoried Building, K.E.M Hospital campus, Parel, Mumbai-400012, India
Fax: 91-22-24138521, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.