ESPE Abstracts

Hypogonadism is represented by a hypo- and hypergonadotropic variant. Antymüllerian hormone (AMH) and inhibin B are used to assess ovarian reserve, but in pediatric practice their role has not been studied. The main interest is to conduct the study of ovarian reserve in hypogonadism among girls.

Objective of the Research: To compare the content of inhibin B, AMH and estradiol in girls with hyper- and hypogonadotropic hypogonadism

Materials and Methods: 25 girls 15.06 ± 1.2 years with delayed puberty are included to study.

Inclusion Criteria: absence of secondary sexual characteristics at the age ≥13 years or absence of menarche at the age ≥ 15 years or absence of menarche for 3 years or more from the onset of estrogen-dependent signs of puberty.

Noninclusion Criteria: age ≥18 years, abnormal external genitalia. The stage of sexual development was assessed on the Tanner scale, LH, FSH, estradiol, inhibin B, AMH, in blood serum, blood karyotyping or FISH analysis on the sex chromosomes, molecular genetic study by parallel sequencing (Ion Torrent platform), custom Ampliseq DSD, hypogonadism, hypopituitarism panels; GnRH analogue test results (triptorelin 0.1 mg). The patients are divided into two groups. The first group – hypergonadotropic hypogonadism (n=16) age 14.78 ± 0.69 years, which consists of: Turner syndrome (n=6), and 10 patients karyotype 46, XX. The second group – hypogonadotropic hypogonadism (n=9), average age 15.06 ± 1.22 years, P= 0.102; congenital hypogonadotropic hypogonadism (n=8), 7 of them are isolated (in 3 cases, GNRHR gene mutation), 1 as part of hypopituitarism, PROP1 gene mutation and 1 acquired hypogonadism after removal of craniopharyngioma.

Results: The serum estradiol content in the two groups did not differ significantly (Me=9 pmol/l [0.28; 50] vs 25.87 pmol/l [9; 48.22], p > 0.05). The inhibin B level (Me=2.25 pg/ml [1.2; 9] vs 14.2 pg/ml [10; 24], P=0.003) and AMH (Me=0.1 ng/ml [0.1; 0.18] Me=2.92 ng/ml [1.22; 8.18], P=0.002) in blood serum in patients with hypergonadotropic hypogonadism, it was significantly lower than in girls with hypogonadotropic hypogonadism.

Conclusion: Comparison of groups with hypo- and hypergonadotropic hypogonadism revealed no difference in the content of estradiol in the blood serum, however, the content of inhibin B and AMH in hypergonadotropic hypogonadism was significantly lower compared with the hypogonadotropic variant of the disease. The obtained results rocket the assessment possibilities of the ovarian reserve in girls with hypogonadism.