ESPE Abstracts

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 0.25–11 months.

Methods: Continuous subcutaneous infusion of rhLH and rhFSH at a daily rate of 50 and 75–150 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.