Amniotic fluid testosterone and testosterone glucuronide levels in the determination of foetal sex

Abstract

Unconjugated testosterone levels were assayed in 351 amniotic fluid samples obtained at 15–19 weeks gestation. The median values for unconjugated testosterone in the 166 female foetuses and 185 male foetuses were 137 and 712pmol/1 respectively. Sixteen amniotic fluid samples from male foetuses had unconjugated testosterone levels lower than the highest female unconjugated testosterone value (361 pmol/1). Testosterone glucuronide was measured in amniotic fluid from 48 female and 55 male foetuses. There was a significant sex difference in the median values of testosterone glucuronide between female (median 160 pmol/1, range 64–465 pmol/1) and male (median 817 pmol/1, range 68–3707 pmol/1) amniotic fluid specimens ( P < 0.001). Of the sixteen male foetuses with amniotic fluid unconjugated testosterone levels in the female range, 12 had amniotic fluid testosterone glucuronide levels within the male testosterone glucuronide range of values. Hence used in conjunction with uneonjugated testosterone, testosterone glucuronide increased the predictive accuracy of foetal sexing from 95.4 to 98.9%. Testosterone sulphate was measured in 24 female and 25 male amniotic fluid samples. There was no significant difference between female (median 2591 pmol/1) and male (median 2964 pmol/1) testosterone sulphate levels.