A Cross Sectional Study of Serum Gonadotropins, Testosterone and Genital Parameters During Mini Puberty in Normal Male Infants

Ashok Kumar; Sunetra Mondal; subhodip Pramanik; Sujoy Ghosh; Manoj Kumar; Rana Bhattacharjee; Subhankar Chowdhury

Introduction: The onset of puberty is preceded by the activity of the hypothalamic-pituitary-gonadal (HPG) axis during infancy known as mini-puberty which is sexually dimorphic and more pronounced in male infants.

Aims and objectives: the main objective was "To study LH(Luteinising hormone), FSH(follicle stimulating hormone) and Testosterone and testicular volume, stretched penile length (SPL) during mini-puberty in males"

Material and Methods: A multipoint single contact cross-sectional study which included 133 consecutive healthy full-term male, taken on day 3 of life (n=46), at 2-6 weeks (n=32),7-12 weeks(n=32), 13-16 weeks (n=18) and five infants > 6 months age. LH, FSH, testosterone were measured by Immulite 1000 CLIA(Chemiluminescent immunometric assay) testicular length, breadth was measured using Vernier Callipers and testicular volume by the formula of ellipsoid(length×width²×pi/6) and SPL(stretched penile length) using Schonfeld's method.

Results: (table)

LH and FSH levels were highest in 2-6 weeks age group and thereafter gradually decreasing values of LH and FSH were observed till 6-12 months age.

Highest Testosterone levels were observed on day 3 of life but not accompanied with rising LH, FSH, possible explanation may be higher levels of the HCG due to decreased metabolic clearance of HCG or high level of SHBG.

SPL mean(SD) at birth was 3.06 ± 0.039cm and 3.85(0.06)cm at 2-6 week, 4.10(0.04)cm at 7-12 week, 4.23(0.05)cm at 13-16 week, and 4.34(0.07)cm at >6 months there was a significant change with the increasing age group.

A change in testicular volume was observed mean(SD) from 0.30 (0.16)ml at birth to 0.43(0.12)ml at 2-6 week, 0.56(0.12)ml at 7-12 week, 0.69(0.18)ml at 13-16 week, and 0.92(0.15)ml at 6 months.There is a gradual increase in the SPL and testicular volume in mini-puberty.

Conclusion: Postnatal gonadal surge is associated with significant change in testicular and genital growth.

Table showing median, range and lower & upper quartiles for the LH, FSH, testosterone in different age .
Age Group	Testosterone(ng/dl) Median(range)LQ-UQ	LH(mIU/ml)	FSH(mIU/ml)
Day 3 N=46	144 (40-330) 91.6-229	0.334(0.1-0.85) 0.1-0.56	0.352(0.12-0.98) 0.2-0.53
2-6 weeks N=32	102.8(38-390) 75.4-170	3.465(1.09-20.9)2.3-5.63	2.02(0.55-6.66)1.25-3.59
7-12 weeks N=32	89.95(36-273)57.5-131	2.385(0.95-6.38)1.54-3.81	1.64(0.62-39.8)1.19-2.13
13-16 weeks N=28	77.45(22-179)43.7-113	1.96(0.81-4.63)1.43-3.21	1.89(0.96-2.96)1.43-2.33
>6 month, N=5	<20	0.315(0.18-0.63)0.21-0.48	1.02(0.43-1.32)0.56-1.25

ESPE Abstracts

P1-276