ESPE Abstracts (2023) 97 RFC6.5

ESPE2023 Rapid Free Communications Pituitary, neuroendocrinology and puberty 1 (6 abstracts)

Efficacy and security of gonadotropin treatment in adolescents with congenital hypogonadotropic hypogonadism

Laura Sayol-Torres 1 , Judith González 2 , Núria Gonzalez 1 , Ariadna Campos 1 , Eduard Mogas 1 , Diego Yeste 1 & Maria Clemente 1


1Hospital Universitari Vall d'Hebrón, Barcelona, Spain. 2Hospital de Palamós, Palamós, Spain


Objective: To describe efficacy and security of treatment protocol with gonadotropins in adolescents with hypogonadotropic hypogonadism (HH).

Methods: Prospective study of patients with HH who received hGH and rhFSH in puberty. HH diagnosed during first months of life or in adolescence (testicular volume<4cc in >16 year-old with FSH<1.2UI/L, testosterone<40ng/dL and GnRH-test with LH-peak<6UI/L)

Treatment protocol: First phase: rFSH 75IU/twice-weekly during 2-4 months. Second phase*: rFSH 75-150IU/twice-weekly + hCG 250IU/twice-weekly during 6-12 months. Third phase*: rFSH 150IU/thrice-weekly + hCG at increasing doses (500IU/thrice-weekly during 6-12 months, 1000IU/thrice-weekly during 6 months, 1500IU/thrice-weekly during 6 months, adult doses 1500-2500IU). *hCG and rhFSH doses adjusted according to testosterone and inhibin-B levels respectively.

Efficacy:• Testicular volume(TV): mean of both testicles(mL) • Testosterone and inhibin-B levels. • Spermiogarm in phase 3 (OMS2010). •Adult height (AH) Z-score and Δadult-height-mean parental height (MillennialsGrowth2018).

Security: Blood count, biochemistry and hormonal analysis performed periodically. BMD at onset and end.

Results: 6 patients described in Table 1. Patients 1 and 4 began pubertal induction with intramuscular testosterone and afterwards, received gonadotropin treatment. The rest, started and completed pubertal induction with gonadotropins presenting normal pubertal development.

Table 1: Parameters in patients that underwent treatment with rhFSH-HCG
Patient Etiology (age at diagnosis) Age at onset(years) Basal TV (mL) mean* Basal InhibinB (pg/mL) Basal testosterone (ng/dL) Duration (years) Final TV (mL) mean* Final InhibinB (pg/mL) AH (cm) Z-score ΔH- mean parental H Spermiogram Nº performance, count and mobility
1 Acquired Idiopathic intracranial hypertension(15 years) 16.6 4.5 23.8 <10 3.6 20 188 172 +0.12 3rd: 100x10E6/mL, 24% progressively mobile, 2% normal
2 Congenital panhypopituitarism (Neonatal) 12.7 2 (inguinal) 25 <7 4.4 7 (scrotal) 105 167 0.6 1st: Azoospermia
3 Kallmann (Neonatal) 14.7 2 20 18 3.4 7 112 146 0.4 1st, 2nd: Azoospermia
4 Acquired Craneofaringioma (14 years) 17.3 3 58 <10 0.8 8 143 185 0 Without result
5 Congenital panhypopituitarism (Neonatal) 14.9 2 31.2 <7 4 7 77 175 1.4 1st: azoospermia 2nd: 0.34x10E6/mL, 83% no-mobility
6 Kallmann (Neonatal) 12.1 1.5 (inguinal) 20.7 39 5.5 9 104 161.6 -0.4 1º: 1.06 X10E6/mL 37% mobile, 14% progressively mobile 63% immobile
*Prader-orchidometer

Conclusions:• Gonadotropin treatment is secure for pubertal induction. • Testicular volume was increased, although limitedly in severe forms. • Spermatogenic response was scant/null in congenital forms with cryptorchidism (except in one patient). • Clinical parameters (onset and severity of gonadotropin deficiency) may predict treatment response. • Low sample-number limits this study; further research is needed.

Volume 97

61st Annual ESPE (ESPE 2023)

The Hague, Netherlands
21 Sep 2023 - 23 Sep 2023

European Society for Paediatric Endocrinology 

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