GnRH Infusion in Females with HypogonadotropicHypogonadism

ANALIA FREIRE; ANDREA ARCARI; GRINSPON RP; MARÍA GABRIELA BALLERINI; NORA SANGUINETTI; BERGADA IGNACIO; ESCOBAR MARÍA EUGENIA; MARÍA GABRIELA ROPELATO; GRYNGARTEN MIRTA

Puerto Varas

Congreso; Congreso de la Sociedad Latinoamericana de endocrinología pediátrica; 2015

Sociedad Latinoamericana de endocrinología pediátrica

Background: Hypogonadotropichypogonadism (HH) in femalesisan uncommon and heterogeneous condition. There is littledataregarding biochemical profile of gonadotropins to furthersubstantiatethe diagnosis.Objective: Toevaluate the gonadotropaic secretion profile afterGnRHinfusion in a female cohort diagnosed with HH.Patients and Methods: GnRHiv infusion test (0?120 min)wereperformed in 17 patients (17.5 ± 2.3 years) with suspicious ofHHfor pubertal delay or primary amenorrhea associated with:Group1(G1)- acquired or congenital pituitary pathology (n = 7)orG2- hypo/anosmia (n = 6) or G3-lack of spontaneous pubertalprogressionafter a brief estrogenic therapy or lack of pubertal clinicalandbiochemical progression for one year (n = 4). LH, FSH at0,15, 30, 45, 60 and 120 min (IFMA) and basal Estradiol (ECLIA)weredetermined. Basal pubertal cutoffs were defined as FSH >1.5IU/Land basal LH >0.3 IU/L.Results: Basal FSH<1.5 IU/L and LH <0.3 IU/L were found in88%and 82% of patients, respectively. All patients had basal E2<15pg/ml. FSH peak occurred in all the patients at 120 minutes(maximum8 IU/L), whereas the occurrence of the LH surge wasvariable(maximum 8.9 IU/L). Areas under the curve of both gonadotropinswerecompared among 3 groups and they did notshowany significant difference. Peaks LH were: G1: 3.4 ± 2.5 IU/L,G2:1.8 ± 0.42 IU/L and G3: 5.2 ± 3 IU/L. FSH peaks were: G1: 3.9 ±2.4IU/L, G2: 3 ± 1 IU/L, and G3: 4.9 ± 2.9 IU/L.Conclusion: Theoccurrence of simultaneous basal FSH <1.5IU/L,basal LH <0.3 IU/L and E2 <15 pg/ml, or peak values LH <8.9orFSH <8 IU/L after the infusion of GnRH support the diagnosisofHH in females suspected of this condition. Patients with hypo/anosmia showedthe lower gonadotropin profile variability.