Boy born after gender preselection following successive gestational androgen excess of maternal luteoma and female disorders of sex development

Objective: To present male gender preselection after successive gestational hyperandrogenism and female pseudohermaphroditism by pregnancy luteomas. Design: Case report. Setting: University-based teaching hospital. Patient(s): We describe herein a gravida who presented two successive 46, XX disorders of sex development with apparent female genitalia with an enlarged clitoris due to maternal androgen excess from pregnancy luteoma. The maternal hyperandrogenemia returned to a normal level and bilateral luteoma regressed spontaneously postpartum. After gender preselection by Y-bearing spermatozoa for intrauterine insemination at the third gestation, a healthy boy was born in spite of the exaggerated maternal androgen production of pregnancy luteoma to avoid 46, XX disorders of sex development. Intervention(s): Y-bearing spermatozoa for intrauterine insemination as male gender preselection. Main Outcome Measure(s): Boy born after gender preselection for intrauterine insemination and cesarean section. Result(s): Healthy boy born without disorder of sex development after antenatal maternal androgen excess of ovarian luteoma. Conclusion(s): Successive pregnancy luteomas associated with maternal hyperandrogenism may cause female disorders of sex development. Male preselection ameliorates the insult of external genitalia ambiguity by antenatal androgen excess in this matter of concern.