Effects of recombinant human LH and hCG on serum and urine LH and androgens in men

Abstract

Both rhCG doses produce a striking increase in serum hCG and T with suppression of serum LH but, at single doses up to 750 IU, rhLH has no influence on serum or urine LH or T. Effective rhLH doping, which relies on a sustained increases in endogenous T, would require much higher and more frequent daily rhLH doses. Use of LH immunoassays optimized for serum to detect rhLH doping by urine LH measurement requires more standardization and validation and, at present, is unreliable. The T : LH ratio is, however, a useful screening test for hCG doping although its utility requires further evaluation.

Human Chorionic Gonadotropin Test: Old Uncertainties, New Perspectives, and Value in 46,XY Disorders of Sex Development

“…Similar peak values of testosterone were found in adult healthy men (18-45 years) about 72-96 h after rhCG injection with a dose of 250 μg or 750 μg (2.2-and 2.6-fold increment, respectively) [Handelsman et al, 2009], suggesting that the lower dose is able to induce the maximum stimulus after a single administration.…”

Androgens

“…This leads to suppression of serum and urine LH, which may be useful corroborative findings to confirm suspected exogenous hCG use, whereas the urine T/E ratio, a marker for exogenous T use, is unaffected by hCG use [63,64] . By contrast, recombinant LH appears to be an ineffective doping agent as administration is unable to increase serum or urine T even at very high (32 times recommended) dose [63] . This lack of efficacy coupled with the need for multiple daily injections and high cost render it implausible as a genuine doping threat although vigilance is still required to detect and deter even irrational doping efforts.…”

“…In men, hCG administration produces a sustained increase in endogenous T production with increased serum and urine T concentrations [63] . This leads to suppression of serum and urine LH, which may be useful corroborative findings to confirm suspected exogenous hCG use, whereas the urine T/E ratio, a marker for exogenous T use, is unaffected by hCG use [63,64] .…”

“…Whether additional knowledge of the UGT2B17 genotype is useful beyond the T/E ratio phenotype remains to be defined [78] . An alternative or corroborative marker for the administration of any exogenous androgen is the urine T/LH ratio [63,64,81] ; however, this measure depends on the validity of urine LH measurements by immunoassays which are validated solely for human serum samples so that they suffer from method-specific bias and only a few are valid for human urine measurements [82] .…”

Annual banned‐substance review: analytical approaches in human sports drug testing

“…[69] In two randomized controlled studies, LH administration did not result in a significant increase in serum or urine LH or T. Moreover, also the ratios T/EpiT or T/LH were not affected. In contrast, hCG application yielded significantly elevated serum and urine concentrations of T as well as suppression of serum and urine LH.…”