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


METHODS
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.
Main
Katharina M
KM
University Department of Growth and Reproduction, Section 5064, National University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. RH04639@RH.DK
Schmidt
Ida M
IM
Toppari
Jorma
J
Skakkebaek
Niels E
NE
D005640:Follicle Stimulating Hormone / Q000097:blood / Q000627:therapeutic use*; D006062:Gonadotropins / Q000097:blood / Q000172:deficiency*; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D007231:Infant, Newborn; D007265:Inhibins / Q000097:blood; D007279:Injections, Subcutaneous; D007986:Luteinizing Hormone / Q000097:blood / Q000627:therapeutic use*; D008297:Male; D011994:Recombinant Proteins / Q000627:therapeutic use; D012016:Reference Values; D013737:Testis / Q000000981:diagnostic imaging / Q000254:growth & development; D014463:Ultrasonography
D006062:Gonadotropins; D011994:Recombinant Proteins; C422364:inhibin B; D007265:Inhibins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone