Early postnatal treatment of hypogonadotropic hypogonadism with recombinant human FSH and LH

University Department of Growth and Reproduction, Section 5064, National University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. RH04639@RH.DK

BACKGROUND: Patients with hypogonadotropic hypogonadism may be diagnosed shortly after birth because of micropenis and cryptorchidism, combined with subnormal LH and FSH concentrations during the postnatal period. OBJECTIVE: To investigate whether treating these patients with gonadotropins postnatally, to mimic the physiological development, would improve testicular growth and fertility potential later in life. DESIGN: Our patient presented with micropenis. Serum hormone concentrations were measured monthly after delivery: LH and testosterone were undetectable, and FSH and inhibin B were below the normal range (0.05-0.17 IU/l and 79-112 pg/ml respectively). METHODS: From 7.9 to 13.7 months of age, the patient was treated with recombinant human LH and FSH in doses of 20 and 21.3 IU s.c. twice weekly respectively. RESULTS: During treatment concentrations of LH, FSH, inhibin B and estradiol increased to values within normal limits (0.7-1.88 IU/l, 0.17-3.24 IU/l, 121-268 pg/ml and 40-55 pmol/l respectively), whereas serum testosterone remained undetectable. Penile length increased from 1.6 to 2.4 cm and testicular volume, assessed by ultrasound, increased by 170%. No significant adverse events were observed. CONCLUSIONS: Gonadotropin treatment in an infant with hypogonadotropic hypogonadism succeeded in inducing an increase in inhibin B and testicular growth.

This article has been cited by other articles:

				P. Bougneres, M. Francois, L. Pantalone, D. Rodrigue, C. Bouvattier, E. Demesteere, D. Roger, and N. Lahlou Effects of an Early Postnatal Treatment of Hypogonadotropic Hypogonadism with a Continuous Subcutaneous Infusion of Recombinant Follicle-Stimulating Hormone and Luteinizing Hormone J. Clin. Endocrinol. Metab., June 1, 2008; 93(6): 2202 - 2205. [Abstract] [Full Text] [PDF]

				T. Raivio, A. M Wikstrom, and L. Dunkel Treatment of gonadotropin-deficient boys with recombinant human FSH: long-term observation and outcome Eur. J. Endocrinol., January 1, 2007; 156(1): 105 - 111. [Abstract] [Full Text] [PDF]

				D. A. van Tijn, E. J. Schroor, H. A. Delemarre-van de Waal, J. J. M. de Vijlder, and T. Vulsma Early Assessment of Hypothalamic-Pituitary-Gonadal Function in Patients with Congenital Hypothyroidism of Central Origin J. Clin. Endocrinol. Metab., January 1, 2007; 92(1): 104 - 109. [Abstract] [Full Text] [PDF]

				K. M Main, J. Toppari, and N. E Skakkebaek Gonadal development and reproductive hormones in infant boys Eur. J. Endocrinol., November 1, 2006; 155(suppl_1): S51 - S57. [Abstract] [Full Text] [PDF]

				K. M. Main, J. Toppari, A.-M. Suomi, M. Kaleva, M. Chellakooty, I. M. Schmidt, H. E. Virtanen, K. A. Boisen, C. M. Kai, I. N. Damgaard, et al. Larger Testes and Higher Inhibin B Levels in Finnish than in Danish Newborn Boys J. Clin. Endocrinol. Metab., July 1, 2006; 91(7): 2732 - 2737. [Abstract] [Full Text] [PDF]

				M. Boas, K. A Boisen, H. E Virtanen, M. Kaleva, A.-M. Suomi, I. M Schmidt, I. N Damgaard, C. M Kai, M. Chellakooty, N. E Skakkebaek, et al. Postnatal penile length and growth rate correlate to serum testosterone levels: a longitudinal study of 1962 normal boys Eur. J. Endocrinol., January 1, 2006; 154(1): 125 - 129. [Abstract] [Full Text] [PDF]

				L. Aksglaede, A. M. Wikstrom, E. R.-D. Meyts, L. Dunkel, N. E. Skakkebaek, and A. Juul Natural history of seminiferous tubule degeneration in Klinefelter syndrome Hum. Reprod. Update, January 1, 2006; 12(1): 39 - 48. [Abstract] [Full Text] [PDF]

				M. M. Grumbach A Window of Opportunity: The Diagnosis of Gonadotropin Deficiency in the Male Infant J. Clin. Endocrinol. Metab., May 1, 2005; 90(5): 3122 - 3127. [Abstract] [Full Text] [PDF]

				N. Lahlou, I. Fennoy, J.-C. Carel, and M. Roger Inhibin B and Anti-Mullerian Hormone, But Not Testosterone Levels, Are Normal in Infants with Nonmosaic Klinefelter Syndrome J. Clin. Endocrinol. Metab., April 1, 2004; 89(4): 1864 - 1868. [Abstract] [Full Text] [PDF]

				L. Maffei, Y. Murata, V. Rochira, G. Tubert, C. Aranda, M. Vazquez, C. D. Clyne, S. Davis, E. R. Simpson, and C. Carani Dysmetabolic Syndrome in a Man with a Novel Mutation of the Aromatase Gene: Effects of Testosterone, Alendronate, and Estradiol Treatment J. Clin. Endocrinol. Metab., January 1, 2004; 89(1): 61 - 70. [Abstract] [Full Text] [PDF]

				M. Chellakooty, I. M. Schmidt, A. M. Haavisto, K. A. Boisen, I. N. Damgaard, C. Mau, J. H. Petersen, A. Juul, N. E. Skakkebaek, and K. M. Main Inhibin A, Inhibin B, Follicle-Stimulating Hormone, Luteinizing Hormone, Estradiol, and Sex Hormone-Binding Globulin Levels in 473 Healthy Infant Girls J. Clin. Endocrinol. Metab., August 1, 2003; 88(8): 3515 - 3520. [Abstract] [Full Text] [PDF]