Anand-Ivell et al. reported that individuals with ambiguous genitalia (hypospadias and cryptorchidism) had elevated levels of INSL3 in the amniotic fluid in the second trimester, compared with those in controls.34 Analyzing the groups separately, the 5ARD2 and PAIS groups showed an increasing trend with regard to INSL3 levels, compared with individuals in the control group. Here, INSL3 is linked to hypospadias.