GnRH Infusion in Females with Hypogonadotropic Hypogonadism

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

Barcelona

Congreso; Annual Meeting of the European Society for Paediatric Endocrinology (ESPE); 2015

European Society for Paediatric Endocrinology (ESPE)

Background: Hypogonadotropic hypogonadism (HH) in femalesis an uncommon and heterogeneous condition. There is littledata regarding biochemical profile of gonadotropins to furthersubstantiate the diagnosis. Objective: To evaluate the gonadotropaic secretion profile afterGnRH infusion in a female cohort diagnosed with HH.Patients and Methods: GnRH iv infusion test (0?120 min)were performed in 17 patients (17.5 ± 2.3 years) with suspicious ofHH for pubertal delay or primary amenorrhea associated with:Group1 (G1)- acquired or congenital pituitary pathology (n = 7)or G2- hypo/anosmia (n = 6) or G3-lack of spontaneous pubertalprogression after a brief estrogenic therapy or lack of pubertal clinicaland biochemical progression for one year (n = 4). LH, FSH at0, 15, 30, 45, 60 and 120 min (IFMA) and basal Estradiol (ECLIA)were determined. Basal pubertal cutoffs were defined as FSH >1.5IU/L and 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<15 pg/ml. FSH peak occurred in all the patients at 120 minutes(maximum 8 IU/L), whereas the occurrence of the LH surge wasvariable (maximum 8.9 IU/L). Areas under the curve of both gonadotropinswere compared among 3 groups and they did notshow any 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 ±2.4 IU/L, G2: 3 ± 1 IU/L, and G3: 4.9 ± 2.9 IU/L.Conclusion: The occurrence of simultaneous basal FSH <1.5IU/L, basal LH <0.3 IU/L and E2 <15 pg/ml, or peak values LH <8.9or FSH <8 IU/L after the infusion of GnRH support the diagnosisof HH in females suspected of this condition. Patients with hypo/anosmia showed the lower gonadotropin profile variability.