Gonadotropin Secretion Profile in Agonadal Boys from Birth to Puberty

GRINSPON, R.; REY, R; GOTTLIEB, S; BEDEACRRÁS, P.; BALLERINI, M.G.; ROPELATO, M.G.

Lima, Perú

Congreso; XX Reunión Anual Sociedad Latinoamericana de Endocrinología Pediátrica; 2008

A preliminary study in 9 agonadal boys demonstrated that gonadotropins have similar changes with age and pubertal stage as in normal boys, but with higher levels. Gonadotropin ultrasensitive assays detected agonadism even in prepubertal boys. The limit of the study was the small sample. The aim of this study was to describe the changes in gonadotropin serum levels in a larger sample of anorchid boys from birth to puberty. We retrospectively analyzed serum concentration of basal FSH and LH (IFMA) in 29 anorchid boys confirmed by no detectable anti- Müllerian hormone (21 with longitudinal follow-up). Between 0 and 6 months (n = 3) LH (median, range) was 73.3 IU/L (39.6-91.6) and FSH 137 IU/L (98.6-137.1). Between 6 months and 4 years (n = 9) LH was 7.2 IU/L (0.5-11.6) and FSH 60.8 IU/L (6.3-130). Up to 4 years gonadotropins were elevated for age in all cases. Between 4 and 10 years (n = 16) LH was 0.30 IU/L (0.05-8.2) and FSH 11.5 IU/L (1-59.7). In this group, 10 patients had at least one normal LH value and 4 patients had at least one normal FSH value. In patients older than 10 years (n = 13), LH was 25 IU/L (8.1-58.1) and FSH 73.9 IU/L (35.5-125). Only one patient had normal LH. In conclusion, most of the patients with anorchia have elevated gonadotropins between birth and puberty. However, between 4 and 10 years, a nadir is observed, where gonadotropins can even fall within the normal range in some patients. In this period of life normal gonadotropins do not rule out anorchia.