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Time Course of the Serum Gonadotropin Surge, Inhibins, and Anti-Müllerian Hormone in Normal Newborn Males during the First Month of Life

Centro de Investigaciones Endocrinológicas and División de Endocrinología (I.B., C.M., P.B., L.A., M.G.R., S.G., C.B., S.C., R.A.R.), Hospital de Niños R. Gutiérrez, C1425EFD Buenos Aires, Argentina; Instituto de Análisis Clínicos (C.M.), B6000FID Junin, Argentina; and Departamento de Histología, Biología Celular, Embriología y Genética (R.A.R.), Facultad de Medicina, Universidad de Buenos Aires, C1121ABG Buenos Aires, Argentina

Address all correspondence and requests for reprints to: Prof. Rodolfo Rey, M.D., Ph.D., CEDIE, Hospital de Niños R. Gutiérrez, Gallo 1330, C1425EFD Buenos Aires, Argentina. E-mail: rodolforey{at}cedie.org.ar.

Context: Newborns with ambiguous genitalia or males with nonpalpable gonads usually require an early assessment of the presence and functional state of testicular tissue.

Objective: Our objective was to characterize the precise ontogeny of the serum patterns of gonadotropins, testosterone, anti-Müllerian hormone (AMH), and inhibins in normal newborn boys.

Design: We conducted a cross-sectional and longitudinal study.

Subjects: Serum samples were obtained in 57 boys and 13 girls on d 2 of life. A second sample was obtained on d 7, 10, 15, 20, and 30 (boys) and on d 30 (girls).

Main Outcome Measures: Serum levels of gonadotropins, testosterone, AMH, and inhibins were measured.

Results: In males, LH and FSH were undetectable or very low on d 2. By d 7, LH increased to 3.94 ± 3.19 IU/liter (mean ± SD) and FSH to 2.04 ± 1.67 IU/liter. LH/FSH ratios were 0.40 ± 0.11 (d 2) and 2.02 ± 0.20 (d 30). AMH rose from 371 ± 168 pmol/liter (d 2) to 699 ± 245 pmol/liter (d 30), and inhibin B rose from 214 ± 86 ng/liter (d 2) to 361 ± 93 ng/liter (d 30). The inhibin -subunit precursor (pro-C) remained stable during the first month of life. Testosterone levels were 66 ± 42 ng/dl (d 2), 82 ± 24 ng/dl (d 20), and 210 ± 130 ng/dl (d 30). A sexual dimorphism was observed in AMH and inhibin B (lower in girls on d 2 and 30), in LH/FSH ratio (lower in girls on d 30) and in testosterone (lower in girls on d 30).

Conclusions: Sertoli cell markers AMH and inhibin B are the earliest useful markers indicating the existence of normal testicular tissue.

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