Polycystic ovary syndrome in women is associated with longer anogenital distance, a new potential biomaker for PCOS

Background Fetal androgen exposure plays a pivotal role in Polycystic ovary syndrome (PCOS) development and may result in elevated Anogenital distance (AGD). This meta-analysis aimed to investigate the clinical link between PCOS and AGD. Methods A literature search was performed across various databases to identify studies evaluating AGD in adults with PCOS and without, regardless of language, up to December 2024. The quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS) scoring system. Random-effects models were utilized to determine mean differences (MDs) and 95% confidence intervals (CIs) in cases of high heterogeneity. This meta-analysis encompassed 4 studies involving a total of 837 participants. Results The pooled analysis found a noteworthy increase of the AGD-ac and AGD-af in PCOS patient compared with the control groups, with an overall MD of AGD-ac = 5.23, 95% CI (2.60, 7.85), P-value < 0.0001, I 2 = 57%, and with an overall MD of AGD-af = 2.19, 95% CI (0.04, 4.35), P-value = 0.05, I 2 = 89%. Conclusion The meta-analysis results indicated that women diagnosed with PCOS exhibit elongated AGD. This potential association between AGD and PCOS could serve as a novel clinical marker for the diagnosis of PCOS. Fetal androgen exposure may play a role in the pathogenesis of PCOS.