Kinetics of the Steroidogenic Response to Single versus Repeated Doses of Human Chorionic Gonadotropin in Boys in Prepuberty and Early Puberty

Dunkel, Leo; Perheentupa, Jaakko; Apter, Dan

doi:10.1203/00006450-198501000-00001

Cited by 32 publications

(10 citation statements)

References 18 publications

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“…It is also known that hCG treatment transiently increases serum androgen concentrations by about 150-fold, i.e. to the levels seen in adult men (Dunkel et al, 1985), followed by a gradual decrease over several weeks. Therefore we decided to study the effects of the dramatic changes in serum androgen levels following treatment of cryptorchidism with hCG on germ cell death and testis development.…”

Section: Treatment Of Cryptorchidism With Hcg Results In Increased Apmentioning

confidence: 99%

Clinical aspects of male germ cell apoptosis during testis development and spermatogenesis

1997

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Apoptosis appears to have an essential role in the control of germ cell number in testes. During spermatogenesis germ cell deletion has been estimated to result in the loss of up to 75% of the potential number of mature sperm cells. At least three factors seem to determine the onset of apoptosis in male germ cells: (1) lack of hormones, especially gonadotropins and androgens; (2) the specific stage in the spermatogenic cycle; (3) and the developmental stage of the animal. Although male germ cell apoptosis has been well characterized in various animal models, few studies are presently available regarding germ cell apoptosis in the human testis. The first part of this review is focused on germ cell apoptosis in testes of prepubertal boys, with special emphasis on apoptosis in normal and cryptorchid testes. A higher percentage of apoptotic spermatogonia was seen in the cryptorchid testes than in the scrotal testes. The hCG-treatment increased the number of apoptotic spermatogonia. The hCG-treatmentinduced apoptosis in spermatogonia had severe long-term consequences in reproductive functions in adulthood. Increased apoptosis after hCG-treatment was associated with subnormal testis volumes, subnormal sperm density and pathologically elevated serum FSH. This finding indicates that increased apoptosis in spermatogonia in prepuberty leads to disruption of testis development. To evaluate the role of apoptosis in human adult testes, apoptosis was induced in seminiferous tubules that were incubated under serum-free conditions in the absence or presence of testosterone. Most frequently apoptosis was identified in spermatocytes. Occasionally some spermatids also showed signs of apoptosis. In short term incubations apoptosis was suppressed by testosterone. Our findings lead to the conclusion that apoptosis is a normal, hormonally controlled phenomenon in the human testis. The role of apoptosis in disorders of spermatogenesis remains to be established.

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Section: Treatment Of Cryptorchidism With Hcg Results In Increased Apmentioning

confidence: 99%

Clinical aspects of male germ cell apoptosis during testis development and spermatogenesis

1997

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“…Previous studies have shown that following a single hCG injection plasma testosterone rises steadily to reach max imal values 4-5 days later [48]. Since a second hCG injection at 24-hour intervals has little [49] or some additional stimulatory effect [50], it would theoretically be unnecessary to repeat the hCG injection before the maximal response has occurred. On the other hand, it has been shown that testosterone levels are comparable after the administration of 4 hCG injections at 5-day [31,49], Therefore, in order to test the above hypotheses, we have compared the effect of these two modes of hCG administration on testicular descent and hormonal response in a population of pre pubertal boys with undescended testes, using the same criteria for selection of patients and estimation of the results.…”

Section: Introductionmentioning

confidence: 99%

Undescended Testis: Comparison of Two Protocols of Treatment with Human Chorionic Gonadotropin

et al. 1988

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A randomized study of two protocols of human chorionic gonadotropin (hCG) treatment was performed in 183 prepubertal boys between 7 months and 12 years of age: protocol I, in which the boys were given 7 injections of 1,500 IU every other day, and protocol II consisting of 4 injections of 100 IU/kg at 4- to 5-day intervals. In both protocols, by the end of the test, testosterone had risen significantly to values within the normal adult male range. However, the amplitude of the rise was slightly but significantly lower using protocol II (4.08 ± 2.07 ng/ml) than protocol I (5.16 ± 2.73 ng/ml). It would thus appear that repetition of the hCG injection at intervals of less than 4 days is unnecessary, and that a total stimulation period of 2–3 weeks is sufficient. Although not correlated with testosterone levels, the success rates for treatment were similar in both protocols and comparable to rates reported in the literature.

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“…The normal mean (+ SD) of basal and hCG-stimulated testosterone values at prepuberty (I) and early puberty (II) in our laboratory as previously reported [8,14] [3,7]. In the present study we focused on the diagnostic significance of the single and repeated dose hCG tests and the kinetics of the steroidogenic response.…”

Section: Resultsmentioning

confidence: 93%

“…Over the years our department found that the use of repeated doses of human chorionic gonadotropin (hCG) for stimulation of testicular steroidogenesis according to the protocol of Perheentupa et al [9] was cumbersome and, in a number of cases, led to a lack of compliance. In 1972 Zachmann [15], and later others [3,4,12], reported that a single-dose hCG test is reliable in the diagnosis of hypogonadism and delayed puberty of various aetiologies.…”

Section: Introductionmentioning

confidence: 98%

Evaluation of human chorionic gonadotropin stimulation tests in prepubertal and early pubertal boys

et al. 1995

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We evaluated the diagnostic significance of single versus repeated human chorionic gonadotropin (hCG) stimulation of testicular steroidogenesis in 25 boys (10 prepubertal group A; 15 early pubertal, group B) with suspected hypogonadism. All subjects received a single injection of hCG (5000 U/1.7 m2) and 1 month later, three repeated injections of 1500 U, one each on alternate days. In 19 out of the 25 boys, testosterone increased normally in both tests: from 20 +/- 6 to 156 +/- 82 ng/dl and from 107 +/- 105 to 615 +/- 293 ng/dl, following a single hCG injection, and from 30 +/- 19 to 439 +/- 298 ng/dl and from 94 +/- 55 to 826 +/- 272 ng/dl, following repeated injections in groups A and B, respectively. The difference between the tests was significant (P < 0.01). Conclusion. Single hCG injection used as a screening test in the evaluation of hypogonadism is conclusive when positive. Only when the initial test is negative may a repeated test help establish the diagnosis.

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Kinetics of the Steroidogenic Response to Single versus Repeated Doses of Human Chorionic Gonadotropin in Boys in Prepuberty and Early Puberty

Cited by 32 publications

References 18 publications

Clinical aspects of male germ cell apoptosis during testis development and spermatogenesis

Clinical aspects of male germ cell apoptosis during testis development and spermatogenesis

Undescended Testis: Comparison of Two Protocols of Treatment with Human Chorionic Gonadotropin

Evaluation of human chorionic gonadotropin stimulation tests in prepubertal and early pubertal boys

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