GnRH Infusion in Females with Hypogonadotropic Hypogonadism

FREIRE A; ARCARI A; GRINSPON R; BALLERINI MG; SANGUINETI N; BERGADÁ I; ESCOBAR ME; ROPELATO MG; GRYNGARTEN M

Barcelona

Congreso; 54th Annual Meeting of the ESPE European Society for Paediatric Endocrinology; 2015

European Society for Paediatric Endocrinology

Background: Hypogonadotropic hypogonadism (HH) infemales is an uncommon and heterogeneous condition. There islittle data regarding biochemical profile of gonadotropins tofurther substantiate the diagnosis. Objective:To evaluate thegonadotropaic secretion profile after GnRH infusion in a femalecohort diagnosed with HH. Patients and methods:GnRH ivinfusion test (0?120 min) were performed in 17 patients (17.5G2.3years) with suspicious of HH for pubertal delay or primaryamenorrhea associated with: Group1 (G1)- acquired or congenitalpituitary pathology (nZ7) or G2- hypo/anosmia (nZ6) or G3- lackof spontaneous pubertal progression after a brief estrogenic therapyor lack of pubertal clinical and biochemical progression for one year(nZ4). LH, FSH at 0, 15, 30, 45, 60 and 120 min (IFMA) and basalEstradiol (ECLIA) were determined. Basal pubertal cutoffs weredefined as FSHO1.5 IU/L and basal LHO0.3 IU/L.Results:BasalFSH!1.5 IU/L and LH!0.3 IU/L were found in 88% and 82% ofpatients, respectively. All patients had basal E2!15 pg/ml. FSHpeak occurred in all the patients at 120 minutes (maximum8 IU/L), whereas the occurrence of the LH surge was variable(maximum 8.9 IU/L). Areas under the curve of both gonadotropins were compared among three groups and they did not showany significant difference. Peaks LH were: G1: 3.4G2.5 IU/L, G2:1.8G0.42 IU/L and G3: 5.2G3 IU/L. FSH peaks were: G1: 3.9G2.4 IU/L, G2: 3G1 IU/L, and G3: 4.9G2.9 IU/L.Conclusion:Theoccurrence of simultaneous basal FSH!1.5 IU/L, basal LH!0.3 IU/L and E2!15 pg/ml, or peak values LH!8.9 or FSH 9 IU/L after the infusion of GnRH support the diagnosis of HH infemales suspected of this condition. Patients with hypo/anosmiashowed the lower gonadotropin profile variability.