Isolated Pituitary Gonadotrophin Deficiency: Gonadotrophin Secretion after Synthetic Luteinizing Hormone and Follicle Stimulating Hormone-releasing Hormone

Marshall, John C.; Harsoulis, P.; Anderson, D. C.; McNeilly, A. S.; Besser, G. M.; Hall, R.

doi:10.1136/bmj.4.5841.643

Cited by 84 publications

(21 citation statements)

References 7 publications

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“…On the basis of other reports (Bardin et al, 1967;Baier & Taubert, 1969;Marshall et al, 1972) and our own results, clomiphene citrate may be considered to act at the hypothalamic level, increasing the endogenous LH-RH and con¬ sequently the synthesis and storage of pituitary gonadotrophins. …”

Section: Effect Of Clomiphene Citrate On Gonadotrophinsmentioning

confidence: 90%

Hypothalamus-Pituitary-Testis Interaction

Franchimont¹,

Chari²,

Demoulin³

1975

Reproduction

115

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The recent observation by Schally & co-authors (1971) that the release of both LH and FSH is dependent upon the one`r eleasing' hormone (LH-RH) has made the study of the hypothalamus\p=m-\pituitary\p=m-\testis axis much more complex. Furthermore, the normal maintenance of both spermatogenesis and testosterone secretion depends upon LH and FSH acting synergistically. It may, therefore, be surmised that there is no absolute specificity of gonadal steroids or other substances in the regulation of secretion of gonadotrophins.Nevertheless, FSH and LH secretion appear to be dissociated in certain pathological conditions. When the Leydig cells are normal but the germinal epithelium has been damaged or destroyed, as after irradiation, certain viral infections, the administration of anti-fertility agents or in idiopathic infertility, the LH levels stay within the normal range whilst those for FSH are elevated (Franchimont, 1966(Franchimont, , 1971(Franchimont, , 1972Paulsen et al., 1968;Rosen & Weintraub, 1971;de Kretser et al., 1972;Leonard et al., 1972; van Thiel et al., 1972).It is intended in this paper to examine the basal secretion of the gonado¬ trophins (mainly LH and to a lesser extent FSH) and the response in males to administration of steroids and LH-RH, and also the relationship between spermatogenesis and gonadotrophins. EFFECT OF ANDROGENS ON GONADOTROPHINSIt is well accepted that the administration of testosterone to males is followed by a decrease in plasma LH levels. The effects on FSH, however, are controversial ( Table 1). The reasons for the conflicting results obtained using virtually the same amounts of testosterone propionate (TP) are obscure. They may reflect the differences in the number of subjects studied, the route of administration, the action of sex hormone-binding protein and/or the particular radioimmuno¬ assay used for FSH determination.In general, TP administered in small doses preferentially suppresses serum LH as compared to serum FSH (Dufy-Barbe & Franchimont, 1972;Swerdloff et al., 1972;Demoulin et al., 1973;Stewart-Bentley et al., 1974). For example, when five normal men were treated intramuscularly with 50 mg TP daily for 5 days, plasma LH levels were lowered but FSH was not affected. The release of FSH and LH is unaffected by the administration of TP if 25 µg LH-RH are given intravenously before treatment (see Text- fig. 1). These results are in agreement with those of von zur Mühlen & Kobberling (1973) who have shown that four intramuscular injections of 100 mg TP for 1 week significantly decreas-335

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Section: Effect Of Clomiphene Citrate On Gonadotrophinsmentioning

confidence: 90%

Hypothalamus-Pituitary-Testis Interaction

Franchimont¹,

Chari²,

Demoulin³

1975

Reproduction

115

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“…If an increase of gonadotropin does not occur, we cannot assure that the defect is in the hypophysis, as there seems to exist a direct relationship be tween FSH and LH basal values and response to the stimulation (4,15). Likewise, the intensity of the response can be in proportion to the previous contact of the Gn-RH with the hypophysis (14,18,20,26). It is also possible that the latter needs a longer stimulation before producing a response (3,9,14,26).…”

Section: Discussionmentioning

confidence: 97%

“…Likewise, the intensity of the response can be in proportion to the previous contact of the Gn-RH with the hypophysis (14,18,20,26). It is also possible that the latter needs a longer stimulation before producing a response (3,9,14,26).…”

Section: Discussionmentioning

confidence: 99%

Impotence Secondary to Postpuberal Hypogonadism

Cruz¹,

Solano²

1979

Eur Urol

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“…This emphasizes the need for reliable diagnostic methods to differentiate patients with hypogonadotrophic hypogonadism from other sub-or infertile males. Tests of hypothalamic and pituitary function, utilizing clomiphene citrate and LH-releasing factor (LH-RF) respectively, have been successfully used (Santen, Leonard, Sheris, Gandy & Paulsen, 1971;Marshall, Harsoulis, Anderson, McNeilly, Besser & Hall, 1972). The performance of these stimulation tests involves the assay of FSH and LH, usually in serum or plasma, and their application has therefore been restricted to a few well-equipped endocrinological centres with radioimmunoassay techniques at their disposal.…”

mentioning

confidence: 99%

Synthetic Lh-Releasing Factor and Clomiphene Stimulation in Oligospermic Males With Normal FSH Excretion

Mauss¹,

Mohnfeld²,

Börsch³

1974

Reproduction

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It now seems reasonably established that males with a severe impairment of testicular tubular function tend to have elevated FSH levels, while, contrary to previous concepts, gonadotrophin levels associated with the syndrome of hypogonadotrophic hypogonadism are not necessarily low but are frequently in the lower normal adult range (Franchimont, Burger & Legros, 1973). This emphasizes the need for reliable diagnostic methods to differentiate patients with hypogonadotrophic hypogonadism from other sub-or infertile males. Tests of hypothalamic and pituitary function, utilizing clomiphene citrate and LH-releasing factor (LH-RF) respectively, have been successfully used (Santen, Leonard, Sheris, Gandy & Paulsen, 1971;Marshall, Harsoulis, Anderson, McNeilly, Besser & Hall, 1972). The performance of these stimulation tests involves the assay of FSH and LH, usually in serum or plasma, and their application has therefore been restricted to a few well-equipped endocrinological centres with radioimmunoassay techniques at their disposal.The development of new immunochemical tests for the assay of FSH and LH by Schuurs & van Wijngaarden (1974) has made possible a simple semiquantitative analysis of urinary gonadotrophins. In a large number of suband infertile males, these tests have yielded results which were in good agreement with current concepts of pituitary-gonadal interrelations (Mauss & B\l=o"\rsch, 1973). Elevated baseline FSH levels were found in 75% of oligospermic males, while the remainder had FSH levels in the normal range despite a low sperm output, suggesting the possibility of at least partial hypothalamic or pituitary insufficiency. In a further investigation of this possibility, the effects of stimulation with clomiphene citrate and LH-RF have been studied in sub-or infertile males, aged 25 to 39 years, with oligospermia (<5x 106 spermatozoa/ml) and a basal FSH excretion in the normal range. Ten healthy medical students, aged 24 to 30 years and with testes of normal volume (>12 ml) as measured by an orchidometer (Schonfeld, 1943) and normal sperm characteristics as defined by Mauss & Börsch (1973), served as controls.Immediately before the clomiphene test, two 24-hr urine samples were collected on consecutive days. The subjects then received 50-mg doses orally * Present address:

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Isolated Pituitary Gonadotrophin Deficiency: Gonadotrophin Secretion after Synthetic Luteinizing Hormone and Follicle Stimulating Hormone-releasing Hormone

Cited by 84 publications

References 7 publications

Hypothalamus-Pituitary-Testis Interaction

Hypothalamus-Pituitary-Testis Interaction

Impotence Secondary to Postpuberal Hypogonadism

Synthetic Lh-Releasing Factor and Clomiphene Stimulation in Oligospermic Males With Normal FSH Excretion

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