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Journal of Clinical Endocrinology & Metabolism, Vol 50, 879-881, Copyright © 1980 by Endocrine Society

ARTICLES

Lack of a biphasic steroid response to single human chorionic gonadotropin administration in patients with isolated gonadotropin deficiency

AG Smals, GF Pieters, PW Kloppenborg, DC Lozekoot and TJ Benraad

Single im administration of 1500 IU hCG evoked a biphasic response of 17-hydroxyprogesterone (17-OHP) and testosterone (T) in six eugonadotropic men, with an early peak after 4 h, a nadir at 5 h, and a second peak 24 and 72 h after hCG loading, respectively. Remarkably, in six patients with isolated gonadotropin deficiency, the early rise of both 17-OHP and T was absent, whereas the late peak was attenuated and somewhat delayed. This lack of an immediate response in these hypogonadotropic patients might be accounted for by the lack of gonadotropin-induced enzyme systems capable of rapid steroid synthesis. In the normal men, the 17-OHP rise was more pronounced than the T increase, and thus, from 4 h on, a gradually rising 17-OHP to T ratio was observed, which reached its maximum 24 h after the hCG injection. In contrast, in the hypogonadotropic patients, the 17-OHP to T ratio did not rise but rather decreased to minimal values 72 h after hCG loading. These data suggest that in normal men, but not in hypogonadotropic patients, hCG may rapidly modify steroidogenesis by temporarily depressing the conversion of 17-OHP to T.


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