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        Genomics Precision Diagnostic > Prenatal > Disorders of Sex Development Precision Panel

        Disorders of Sex Development  Precision Panel

        Disorders of Sex Development (DSD), formerly termed intersex conditions, occur when there is a discrepancy between the appearance of the genitalia and the genetic makeup of an individual. These disorders can present from birth to adolescence.
        Overview
        Indication
        Clinical Utility
        Genes & Diseases
        Methodology
        References

        Overview

        • Disorders of Sex Development (DSD), formerly termed intersex conditions, occur when there is a discrepancy between the appearance of the genitalia and the genetic makeup of an individual. These disorders can present from birth to adolescence. DSD can be mild or significant depending on the appearance of the genitalia and associated symptoms. DSD can be caused by changes at a chromosomal level and gene level thus the inheritance pattern of DSDs can be dominant, recessive or sex-linked. Additionally, DSDs can occur due to de novo changes in the DNA (for the first time in the affected individual).

        • The Igenomix Disorders of Sex Development Precision Panel can be used to make a directed and accurate differential diagnosis of ambiguous genitalia ultimately leading to a better management and prognosis of the disease. It provides a comprehensive analysis of the genes involved in this disease using next-generation sequencing (NGS) to fully understand the spectrum of relevant genes involved.  

        Indication

        • The Igenomix Disorders of Sex Development Precision Panel is indicated for those patients with clinical suspicion of an intersex condition presenting with the following manifestations:   
          • Family history of genital ambiguity  
          • History of early death of infants 
          • Maternal drug ingestion 
          • Ambiguous genitalia  
          • Abnormal size and degree of differentiation of phallus  
          • Abnormal position of urethral meatus  
          • Separated labioscrotal folds  
          • Labioscrotal folds with increased pigmentation

        Clinical Utility

        The clinical utility of this panel is: 

        • The genetic and molecular confirmation for an accurate clinical diagnosis of a symptomatic patient.
        • Early initiation of treatment with a multidisciplinary team for early surgical reconstruction, psychosocial aids and pharmacologic treatment. 
        • Risk assessment of asymptomatic family members according to the mode of inheritance. 

        Genes & Diseases

        See all genes and diseases

         

        GENE 

        OMIM DISEASES 

        INHERITANCE* 

        % GENE COVERAGE (20X) 

        HGMD** 

        AKR1C2 

        46,XY Sex
        Reversal 8
         

        AR 

        91.52% 

        5 of 7 

        AKR1C3 

        Prostate Cancer,
        Endometrial Cancer,
        Breast Cancer,
        Skin Squamous
        Cell Carcinoma
         

        – 

        96.97% 

        2 of 2 

        AMH 

        Persistent Mullerian
        Duct Syndrome
        Types 1 and 2
         

        AR 

        98.17% 

        76 of 96 

        AMHR2 

        Persistent Mullerian
        Duct Syndrome
        Types 1 and 2
         

        AR 

        100% 

        87 of 95 

        ANOS1 

        Hypogonadotropic
        Hypogonadism 1 With
        Or Without Anosmia, 
        Kallmann Syndrome, 
        Normosmic Congenital
        Hypogonadotropic
        Hypogonadism,
         

        X,XR,G 

        96.86% 

        NA of NA 

        AR 

        Androgen Insensitivity
        Syndrome, X-linked
        Hypospadias, Kennedy Disease,
        Partial Androgen Insensitivity
        Syndrome, Prostate Cancer, 
        Reifenstein Syndrome, X-linked
        Spinal And Bulbar Muscular
        Atrophy
         

        AD,X,XR,G 

        97.96% 

        NA of NA 

        ARX 

        Corpus Callosum
        Agenesis-Abnormal
        Genitalia Syndrome,
        Early Infantile Epileptic
        Encephalopathy,
        X-linked Lissencephaly
        With Abnormal Genitalia,
        X-linked
        Mental Retardation,
        Partington Syndrome,
        West Syndrome,
        X-linked Non-Syndromic Intellectual
        Disability, X-linked
        Spasticity-Intellectual
        Disability-Epilepsy Syndrome
         

        X,XR,G 

        81.92% 

        NA of NA 

        ATRX 

        Alpha-Thalassemia
        Myelodysplasia Syndrome,
        Carpenter-Waziri Syndrome, 
        Chudley-Lowry-Hoar Syndrome,
        Holmes-Gang Syndrome, 
        Juberg-Marsidi Syndrome,
        X-Linked Mental
        Retardation-Hypotonic
        Facies
        Syndrome, Neuroendocrine 
        Tumor Of Stomach,
        Smith-Fineman-Myers
        Syndrome
         

        X,XR,XD,G 

        98.50% 

        NA of NA 

        BCOR 

        Acute Promyelocytic
         Leukemia
        Lenz Type Microphthalmia,
         
        Oculofaciocardiodental
         Syndrome 

        X,XD,G 

        99.87% 

        NA of NA 

        CBX2 

        46,XY Complete Gonadal
        Dysgenesis,46XY
        Sex 
        Reversal 

        AR 

        100% 

        6 of 6 

        CDK9 

        Primary Immunodeficiency,
        Multiple Myeloma,
        NUT Midline Carcinoma
         

         

        82.69% 

        2 of 2 

        CDKN1C 

        Beckwith-Wiedemann
        Syndrome,
        IMAGE Syndrome,
        Intrauterine Growth
        Restriction-Short
        Stature-Early
        Adult-Onset Diabetes Syndrome,
        Intrauterine Growth Retardation,
        Metaphyseal Dysplasia, Adrenal
        Hypoplasia Congenita,
        And Genital Anomalies
         

        AD 

        73.58% 

        55 of 76 

        CEP41 

        Joubert Syndrome 

        AR 

        100% 

        17 of 17 

        CHD7 

        CHARGE Syndrome, 
        Hypogonadotropic 
        Hypogonadism
         With Or Without Anosmia, 
        Kallmann Syndrome,
         
        Normosmic Congenital
         Hypogonadotropic 
        Hypogonadism, 
        Omenn Syndrome 

        AD 

        96.25% 

        823 of 896 

        CITED4 

        Adult Oligodendroglioma,
        Breast Cancer
         

         

        65.14% 

        NA of NA 

        CREBBP 

        Menke-Hennekam Syndrome,
        Rubinstein-
        Taybi Syndrome 

        AD 

        100% 

        318 of 318 

        CYB5A 

        46,XY Disorder Of Sex
        Development Due To Isolated
        17,20-Lyase Deficiency,
        Hereditary Methemoglobinemia
        And Ambiguous Genitalia
         

        AR 

        100% 

        5 of 5 

        CYP11A1 

        46,XY Disorder Of Sex
        Development-Adrenal
        Insufficiency Due To
        Cyp11a1 Deficiency
         

         

        100% 

        39 of 39 

        CYP11B1 

        Congenital Adrenal 
        Hyperplasia Due To 
        Steroid 11-Beta-Hydroxylase
        Deficiency, Familial 
        Hyperaldosteronism Type I,
        Glucocorticoid-Remediable 
        Aldosteronism 

        AD,AR 

        100% 

        144 of 144 

        CYP17A1 

        46,XY Disorder Of Sex
        Development Due To Isolated
        17,20-Lyase Deficiency,
        Congenital Adrenal Hyperplasia
        Due To 17-Alpha-Hydroxylase
        Deficiency
         

        AR 

        100% 

        127 of 127 

        CYP19A1 

        Aromatase Deficiency,
         
        Aromatase Excess 
        Syndrome 

        AD,AR 

        100% 

        33 of 35 

        CYP21A2 

        Congenital Adrenal
         
        Hyperplasia
         Due To 21-Hydroxylase Deficiency 

        AR 

        99.98% 

        278 of 280 

        DHCR7 

        Smith-Lemli–Opitz 
        Syndrome 

        AR 

        100% 

        217 of 217 

        DHH 

        46,XY Complete Gonadal
         
        Dysgenesis 

        AR 

        99.85% 

        21 of 21 

        DYNC2H1 

        Jeune Syndrome,
        Short Rib-Polydactyly
        Syndrome,
        X,Short-Rib Thoracic
        Dysplasia With
        Or Without Polydactyly
         

        AR,MU,D 

        99.78% 

        214 of 221 

        EMX2 

        Schizencephaly 

         

        100% 

        5 of 5 

        ERCC3 

        Trichothiodystrophy,
        Xeroderma
        Pigmentosum-Cockayne
        Syndrome Complex
         

        AR 

        99.98% 

        24 of 24 

        FEZF1 

        Hypogonadotropic
        Hypogonadism With
        Or Without Anosmia,
         
        Kallmann Syndrome 

        AR 

        99.95% 

        3 of 3 

        FGF8 

        Alobar Holoprosencephaly,
        Hypogonadotropic
        Hypogonadism
        With Or Without Anosmia, 
        Kallmann Syndrome 

        AD 

        98.36% 

        38 of 38 

        FGFR1 

        Encephalocraniocutaneous
         Lipomatosis,
         
        Hartsfield Syndrome, 
        Isolated Trigonocephaly,
        Jackson-Weiss 
        Syndrome,
         
        Kallmann Syndrome,
        Lobar 
        Holoprosencephaly,
        Microform
         Holoprosencephaly,
         
        Normosmic Congenital 
        Hypogonadotropic
         Hypogonadism,
         
        Oligodontia, 
        Osteoglophonic Dysplasia,
        Pfeiffer 
        Syndrome,
        Septo-
        Optic Dysplasia 
        Spectrum,
         
        Nonsyndromic 
        Trigonocephaly 

        AD 

        100% 

        279 of 280 

        FIG4 

        Amyotrophic Lateral Sclerosis,
        Bilateral Parasagittal
        Parieto-Occipital
        Polymicrogyria,
        Charcot-Marie-Tooth Disease,
        Cleidocranial Dysplasia With
        Micrognathia, Absent Thumbs
        And Distal, Polymicrogyria,
        Bilateral Temporooccipital,
        Yunis-
        Varon Syndrome 

        AD,AR 

        99.92% 

        72 of 72 

        FOXL2 

        Blepharophimosis,
        Ptosis, And Epicanthus Inversus,
        Premature Ovarian Failure
         

        AD 

        89.36% 

        136 of 201 

        FRAS1 

        Fraser Syndrome 

        AR 

        98.73% 

        57 of 58 

        GNRH1 

        Hypogonadotropic
        Hypogonadism With Or
        Without Anosmia,
         
        Normosmic Congenital
        Hypogonadotropic
        Hypogonadism
         

        AR 

        100% 

        12 of 12 

        GNRHR 

        Hypogonadotropic
         Hypogonadism Without 
        Anosmia,
         
        Normosmic Congenital
         Hypogonadotropic 
        Hypogonadism 

        AR 

        100% 

        59 of 59 

        HSD17B3 

        46,XY Disorder Of Sex
        Development Due To
        17-Beta-Hydroxysteroid
        Dehydrogenase Deficiency,
        Male
        Pseudohermaphroditism
         With Gynecomastia 

        AR 

        100% 

        61 of 61 

        HSD3B2 

        Congenital Adrenal 
        Hyperplasia Due To
         3-Beta-Hydroxysteroid
         
        Dehydrogenase Deficiency, 
        Congenital Adrenal 
        Hyperplasia Due To 
        3-Beta-Hydroxysteroid
         
        Dehydrogenase Deficiency 

        AR 

        100% 

        70 of 70 

        IL17RD 

        Hypogonadotropic
        Hypogonadism With
        Or Without Anosmia, 
        Kallmann Syndrome 

        AD,AR 

        99.95% 

        17 of 17 

        IRF6 

        Autosomal Dominant
        Popliteal Pterygium
        Syndrome, Cleft Lip
        And Alveolus, Cleft Lip/Palate,
        Isolated Cleft Lip, Oligodontia,
        Orofacial Cleft, Van Der 
        Woude
         Syndrome 

        AD,MU,P 

        99.98% 

        325 of 335 

        KISS1 

        Hypogonadotropic
        Hypogonadism With Or
        Without Anosmia,
         
        Normosmic Congenital
        Hypogonadotropic
        Hypogonadism
         

        AR 

        100% 

        9 of 10 

        KISS1R 

        Hypogonadotropic
        Hypogonadism With Or
        Without Anosmia,
         
        Kallmann Syndrome,
         
        Normosmic Congenital
        Hypogonadotropic Hypogonadism,
        Central Precocious Puberty
         

        AD,AR 

        99.41% 

        42 of 43 

        LHB 

        Hypogonadotropic 
        Hypogonadism Without 
        Anosmia
         

        AR 

        100% 

        11 of 11 

        LHCGR 

        Familial Male-Limited
        Precocious Puberty,
        Hypergonadotropic Hypogonadism,
        Precocious Puberty,
        Male-limited
         

        AD,AR 

        100% 

        75 of 75 

        LHX9 

        Gonadal Agenesis,
        46 XY Sex Reversal
         

         

        99.65% 

        1 of 1 

        MAMLD1 

        X-linked Hypospadias,
        X-linked Myotubular
        Myopathy-Abnormal
        Genitalia Syndrome
         

        X,XR,G 

        99.87% 

        NA of NA 

        MAP3K1 

        46,XY Complete Gonadal 
        Dysgenesis, 46 XY Partial
         Gonadal Dysgenesis, 46
        XY Sex 
        Reversal 

        AD 

        96.50% 

        31 of 32 

        MKRN3 

        Prader-Willi Syndrome,
        Central Precocious Puberty
         

        AD,ADWMI 

        99.98% 

        39 of 41 

        MKS1 

        Bardet-Biedl Syndrome,
        Joubert Syndrome,
        Meckel Syndrome
         

        AR 

        99.98% 

        49 of 49 

        NR0B1 

        46,XX Testicular Disorder
        Of Sex Development,
        46XY Complete Gonadal
        Dysgenesis, 46XY Partial
        Gonadal Dysgenesis,
        Congenital Adrenal Hypoplasia,
        Dosage-Sensitive Sex Reversal
         

        X,XR,G 

        99.87% 

        NA of NA 

        NR5A1 

        46,XX Gonadal Dysgenesis,
        46 XX 
        Ovotesticular Disorder
        Of Sex Development,46 XX
        Sex Reversal, 46 XX Testicular
        Disorder Of Sex Development,
        46 XY Complete Gonadal
        Dysgenesis, 46 XY Partial
        Gonadal Dysgenesis, 46 XY
        Sex Reversal, Male Infertility
        With Azoospermia Or 
        Oligozoospermia Due To
        Single Gene Mutation,
        Premature Ovarian Failure,
        Spermatogenic Failure
         

        AD 

        99.97% 

        222 of 224 

        POR 

        Antley-Bixler Syndrome
        With Genital Anomalies
        And Disordered
        Steroidogenesis,
        Congenital Adrenal
        Hyperplasia Due To
        Cytochrome P450
        Oxidoreductase Deficiency,
        Disordered Steroidogenesis
        Due To Cytochrome P450
        Oxidoreductase
         

        AD,AR 

        99.98% 

        67 of 68 

        PROK2 

        Hypogonadotropic
        Hypogonadism With
        Or Without Anosmia, 
        Kallmann Syndrome, 
        Normosmic Congenital
        Hypogonadotropic
        Hypogonadism
         

        AD 

        100% 

        20 of 20 

        PROKR2 

        Hypogonadotropic
        Hypogonadism With
        Or Without Anosmia,
        Kallmann Syndrome,
         
        Normosmic Congenital
        Hypogonadotropic
        Hypogonadism,
        Pituitary Stalk Interruption
        Syndrome, 
        Septo-Optic Dysplasia
        Spectrum
         

        AD 

        100% 

        64 of 64 

        RSPO1 

        Palmoplantar
        Hyperkeratosis With
        Squamous Cell Carcinoma
        Of Skin, 46 XX Sex Reversal,
        Palmoplantar Keratoderma
         

        AR 

        100% 

        6 of 7 

        SAMD9 

        Mirage Syndrome,
        Familial 
        Normophosphatemic 
        Tumoral Calcinosis
         

        AD,AR 

        99.72% 

        45 of 46 

        SGPL1 

        Nephrotic Syndrome 

        AR 

        98.96% 

        18 of 18 

        SOX10 

        Kallmann Syndrome,
        Peripheral Demyelinating
        Neuropathy-Central 
        Dysmyelinating 
        Leukodystrophy,
        Waardenburg Syndrome,
        Hirschsprung Disease,
        Peripheral Demyelinating
        Neuropathy,
        Central
        Dysmyelination 

        AD 

        99.74% 

        139 of 147 

        SOX13 

        Metastatic Cancer Disease 

         

        100% 

        1 of 1 

        SOX3 

        46, XX Testicular Disorder
        Of Sex Development,
        X-linked Mental Retardation
        With Isolated
        Growth Hormone Deficiency,
        Non-Acquired Panhypopituitarism,
        X-linked Panhypopituitarism, 
        Septo-Optic Dysplasia
        Spectrum
         

        X,G 

        92.88% 

        NA of NA 

        SOX9 

        46,XX Ovotesticular 
        Disorder Of Sex Development,
        46 XX Testicular Disorder Of
        Sex Development, 46 XY
        Complete Gonadal Dysgenesis,
        46XY Partial Gonadal Dysgenesis,
        Campomelic Dysplasia,
        Isolated Pierre Robin Syndrome
         

        AD 

        97.28% 

        87 of 95 

        SRD5A2 

        46,XY Disorder Of Sex
        Development Due To
        5-Alpha-Reductase Deficiency,
        Pseudovaginal Perineoscrotal
         Hypospadias 

        AR 

        na 

        na 

        SRY 

        45X/46 XY Mixed
        Gonadal Dysgenesis,
        46 XX 
        Ovotesticular
         Disorder
        Of Sex Development,
        46XX Testicular Disorder
        Of Sex Development,
        46XY Complete Gonadal
        Dysgenesis, 46XY Partial
        Gonadal Dysgenesis, 46XX
        ÇSex Reversal, 46XY Sex
        Reversal
         

        X,XD,Y,G 

        45% 

        NA of NA 

        STAR 

        Familial Glucocorticoid 
        Deficiency, 
        Lipoid Congenital
         Adrenal Hyperplasia 

        AR 

        100% 

        80 of 80 

        TAC3 

        Hypogonadotropic
        Hypogonadism With
        Or Without Anosmia,
         
        Normosmic Congenital
        Hypogonadotropic
        Hypogonadism
         

        AR 

        100% 

        10 of 10 

        TACR3 

        Hypogonadotropic
        Hypogonadism With
        Or Without Anosmia,
         
        Kallmann Syndrome, 
        Normosmic Congenital
        Hypogonadotropic
        Hypogonadism
         

        AR 

        99.97% 

        40 of 40 

        TOE1 

        Pontocerebellar 
        Hypoplasia 

        AR 

        99.98% 

        12 of 12 

        TSPYL1 

        Sudden Infant
        Death With Dysgenesis
        Of The Testes
        Syndrome
         

        AR 

        99.92% 

        8 of 8 

        WDR11 

        Hypogonadotropic
        Hypogonadism With
        Or Without Anosmia,
         
        Kallmann Syndrome,
         
        Normosmic Congenital
        Hypogonadotropic
        Hypogonadism,
        Pituitary Stalk
        Interruption Syndrome
         

        AD,AR 

        100% 

        19 of 19 

        WT1 

        46 XY Complete
        Gonadal 
        Dysgenesis,
        46 XY 
        Partial Gonadal 
        Dysgenesis, Aniridia, 
        Denys-Drash Syndrome,
         
        Desmoplastic 
        Small Round Cell Tumor, 
        Frasier Syndrome, 
        Meacham Syndrome,
         
        Mesothelioma, Malignant,
         
        Nephroblastoma, 
        Nephrotic Syndrome,
        WAGR 
        Syndrome,
        Wilms Tumor, Aniridia, 
        Genitourinary Anomalies,
        And Mental 
        Retardation 
        Syndrome Chromosome
         11p13 Deletion Syndrome 

        AD 

        98.92% 

        178 of 185 

        ZFPM2 

        46 XY Partial Gonadal Dysgenesis,
        46 XY Sex Reversal,
        Congenital
        Diaphragmatic Hernia,
        Tetralogy Of Fallot
         

        AD 

        99.40% 

        44 of 46 

        * Inheritance: AD: Autosomal Dominant; AR: Autosomal Recessive; X: X linked; XLR: X linked Recessive; Mi: Mitochondrial; Mu: Multifactorial 

        ** HGMD: Number of clinically relevant mutations according to HGMD

        Methodology

        References

        See scientific referrals

        Witchel S. F. (2018). Disorders of sex development. Best practice & research. Clinical obstetrics & gynaecology, 48, 90–102. https://doi.org/10.1016/j.bpobgyn.2017.11.005  

        Lee, P. A., Nordenström, A., Houk, C. P., Ahmed, S. F., Auchus, R., Baratz, A., Baratz Dalke, K., Liao, L. M., Lin-Su, K., Looijenga, L. H., 3rd, Mazur, T., Meyer-Bahlburg, H. F., Mouriquand, P., Quigley, C. A., Sandberg, D. E., Vilain, E., Witchel, S., & Global DSD Update Consortium (2016). Global Disorders of Sex Development Update since 2006: Perceptions, Approach and Care. Hormone research in paediatrics, 85(3), 158–180. https://doi.org/10.1159/000442975 

        Houk, C., & Lee, P. (2012). Update on disorders of sex development. Current Opinion In Endocrinology & Diabetes And Obesity, 19(1), 28-32. doi: 10.1097/med.0b013e32834edacb 

        Hughes, I., Houk, C., Ahmed, S., & Lee, P. (2006). Consensus statement on management of intersex disorders. Journal Of Pediatric Urology, 2(3), 148-162. doi: 10.1016/j.jpurol.2006.03.004 

        Yatsenko, S. A., & Witchel, S. F. (2017). Genetic approach to ambiguous genitalia and disorders of sex development: What clinicians need to know. Seminars in perinatology, 41(4), 232–243. https://doi.org/10.1053/j.semperi.2017.03.016 

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