ESPE2021 ePoster Category 1 Pituitary B (10 abstracts)
Continuous versus discontinuous administration of gonadotropin in neonates with congenital hypogonadotropic hypogonadism
Tristan Avril 1 , Quentin Hennocq 2 , Anne-Sophie Lambert 1 , Dominique Simon 2 , Juliane Leger 2 , Laetitia Martinerie 2 & Claire Bouvattier 1
1APHP, Bicêtre, France; 2APHP, Paris, France
Context: Newborns with Congenital hypogonadotropic hypogonadism (CHH) have an impaired postnatal activation of the gonadotropic axis. Substitutive therapy with recombinant gonadotropins can be proposed to mimic physiological male mini-puberty during the first months of life.
Objective: To retrospectively compare the clinical (penile size, volume and testicular descent) and biological efficacy (serum concentrations of testosterone, AMH and Inhibin B) of two treatment modalities of gonadotropins administration during mini-puberty in CHH neonates.
Patients: Thirty-five patients were included, 18 with continuous administration of recombinant gonadotropins by pump (P group) and 17 with subcutaneous injections (I group). The mean age at treatment initiation in the P group was 5.2 +/-3.5 months compared to 13 +/-17.8 months in the I group.
Results: A significantly higher increase in penile length and testosterone level were observed in the I group compared to the P group (+ 0.16 +/-0.02 mm vs + 0.10 +/-0.02 mm per day and + 0.04 +/-0.007 ng/ml vs + 0.01 +/-0.008 ng/ml per day). In both groups, significant increase in penile width, testicular volume, height, AMH, Inhibin B and FSH levels were observed, as well as improved testicular descent (OR of not being in a scrotal position at the end of treatment = 0.97 [0.96; 0.99]).
Conclusions: Early postnatal administration of recombinant gonadotropins in CHH boys is effective in stimulating penile growth, gonadal development, Sertoli cell proliferation and testicular descent, independently from treatment modalities. Based on our clinical and biological results the best option could be continuous administration of optimized dosages of recombinant gonadotropins.
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