Embryology and endocrinology of genital development.
Level 5 - mechanism / opinion, no new human data
Narrative review summarizing biological mechanisms without systematic review methodology or new human data.
PubMed 9890060 · doi:10.1016/s0950-351x(98)80427-8
What was done
This narrative review summarizes the embryological and hormonal mechanisms governing human fetal sexual differentiation, focusing on the roles of anti-müllerian hormone (AMH), testosterone, and dihydrotestosterone (DHT), as well as the genetic basis of persistent müllerian duct syndrome.
What was found
The abstract reports no numerical or quantitative data. It details the established physiological sequence: fetal testes develop by week 7 and secrete AMH to regress müllerian ducts and testosterone to differentiate wolffian ducts into epididymes, vasa deferentia, and seminal vesicles. Conversion of testosterone to DHT drives masculinization of the urogenital sinus and external genitalia. In the absence of AMH and androgen action, female internal and external genitalia develop. Mutations in AMH or its receptor gene impair this pathway, leading to persistent müllerian duct syndrome in otherwise virilized males.
Why it matters
It outlines the dual hormonal control required for male sexual differentiation and highlights the specific genetic lesions underlying persistent müllerian duct syndrome.
Limits
The abstract provides a descriptive overview with no empirical data, sample size, or systematic methodology. It does not evaluate clinical outcomes, diagnostic accuracy, or non-genetic contributors to disorders of sex development.
Cited by
- supports The inner portion of the human vagina is embryologically derived from the Müllerian ducts.