Context: Cryptorchidism, a common consequence of HH, is treated with orchiopexy. We previously observed that continuous subcutaneous infusion of gonadotropins restored normal serum testosterone and inhibin B concentrations in two infants with hypogonadotropic hypogonadism (HH) and was associated with testicular descent in one.
Objective: Test if subcutaneous gonadotropin infusion within the first year of life can allow testicular descent in eight boys with HH and bilateral cryptorchidism, aged 0.2511 months.
Methods: Continuous subcutaneous infusion of rhLH and rhFSH at a daily rate of 50 and 75150 UI, respectively, aiming at AMH and inhibin B levels normally observed during postnatal mini-puberty.
Results: In response to gonadotropin infusion, serum LH and FSH increased to 4.6±1.3 and 33±9 UI/ml, inhibin B 369±145 pg/ml, AMH 748±361 pmol/ml, testosterone 3.6±1.4 ng/ml. Testicular descent was bilateral in 6/8 patients after 3.6±1.7 months of treatment and unilateral in 1/8. Testes re-ascension in one case was treated by surgery. Testes and penis reached normal dimensions.
Conclusion: Gonadotropin infusion in early infancy seems able to induce complete testicular descent in most cases of cryptorchidism due to HH. If confirmed, this may allow infants to avoid surgical correction.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology