Inhibin A Production after Gonadotropin Stimulus: A New Method to Detect Ovarian Tissue in Ovotesticular Disorder of Sex Development

Abstract

Background/Aims: While laboratory methods for the detection of testicular tissue are well standardized, currently there is no available test to demonstrate the presence of ovarian tissue. We evaluated the effectiveness of gonadal stimulation with luteinizing hormone (LH)/follicle-stimulating hormone (FSH) for the detection of ovarian tissue in patients with disorders of sex development (DSD). Methods: Ten patients with congenital adrenal hyperplasia (CAH) as ovarian-positive controls, 10 with cryptorchidism (ovarian-negative controls), 13 patients with DSD of no defined etiology and 7 patients with ovotesticular DSD (true hermaphroditism, TH) were included in the study. They underwent a daily injection of both LH and FSH on 3 consecutive days. LH, FSH, estradiol, testosterone and inhibin A were measured before treatment, 24 h after the 1st dose and 24 h after the 3rd dose. Results: Estradiol increased in all CAH and TH patients, with a median value of 155.1 and 92.6 pg/ml, respectively, after the 3rd injection. Inhibin A also increased in all CAH and TH patients, with a median value of 70.4 and 32.2 pg/ml, respectively, after the 3rd injection. There was no change in these hormones in the other groups. Conclusion: The LH/FSH stimulation test might be a useful method to detect the presence of ovarian tissue.

Evaluation and treatment for ovotesticular disorder of sex development (OT-DSD) - experience based on a Chinese series

“…One month after surgery, for patient reassigned as female, human menopausal gonadotropins (HMG) test [8] with a daily intramuscular dose of 150 IU on 3 consecutive days was indicated to verify no residuary testicle tissue. While for patients reassigned as male, HCG test was carried out to confirm no residuary ovarian tissue.…”

FSH Injections and Ultrasonography Determine Presence of Ovarian Components in the Evaluation of Ovotesticular Disorders of Sex Development

“…The study cohort included patients with DSD (mean age: 8.4 years) and females with congenital adrenal hyperplasia (CAH) as the positive-ovarian tissue controls [13]. The subjects received the adult recommended dose of LH/FSH, 150 IU, subcutaneously daily for a total of 3 days [13].…”

Sinnvolle Diagnostik bei Besonderheiten der Geschlechtsentwicklung/Reasonable diagnostic pathways in disorders of sex development

“…Wenn ovarielles Gewebe nachgewiesen werden soll, so hat sich die Durchf ü hrung eines Stimulationstests mit humanem Menopausengonadotropin (hMG) bew ä hrt. HMG f ü hrt zu einer Stimulation der Thekazellen und damit normalerweise zu einem deutlichen Anstieg der Konzentrationen von Inhibin-A und Estradiol [10] .…”