Inhibin A production after gonadotropin stimulus: a new method to detect ovarian tissue in ovotesticular disorder of sex development.
OBJECTIVE
While laboratory methods for the detection of testicular tissue are well standardized, currently there is no available test to demonstrate the presence of ovarian tissue. We evaluated the effectiveness of gonadal stimulation with luteinizing hormone (LH)/follicle-stimulating hormone (FSH) for the detection of ovarian tissue in patients with disorders of sex development (DSD).


METHODS
Ten patients with congenital adrenal hyperplasia (CAH) as ovarian-positive controls, 10 with cryptorchidism (ovarian-negative controls), 13 patients with DSD of no defined etiology and 7 patients with ovotesticular DSD (true hermaphroditism, TH) were included in the study. They underwent a daily injection of both LH and FSH on 3 consecutive days. LH, FSH, estradiol, testosterone and inhibin A were measured before treatment, 24 h after the 1st dose and 24 h after the 3rd dose.


RESULTS
Estradiol increased in all CAH and TH patients, with a median value of 155.1 and 92.6 pg/ml, respectively, after the 3rd injection. Inhibin A also increased in all CAH and TH patients, with a median value of 70.4 and 32.2 pg/ml, respectively, after the 3rd injection. There was no change in these hormones in the other groups.


CONCLUSIONS
The LH/FSH stimulation test might be a useful method to detect the presence of ovarian tissue.
Steinmetz
L
L
Pediatric Endocrinology Unit, Instituto da Criança, Hospital das Clínicas, São Paulo University Medical School, São Paulo, Brazil. leandras@uol.com.br
Rocha
M N
MN
Longui
C A
CA
Damiani
D
D
Dichtchekenian
V
V
Setian
N
N
Damiani
D
D
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D012734:Disorders of Sex Development / Q000097:blood*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006728:Hormones / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007265:Inhibins / Q000097:blood*; D007986:Luteinizing Hormone / Q000008:administration & dosage*; D008297:Male; D010053:Ovary
D006728:Hormones; C422362:inhibin A; D004958:Estradiol; D007265:Inhibins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone