Pubertal induction in hypogonadism: Current approaches including use of gonadotrophins

Zacharin, Margaret

doi:10.1016/j.beem.2015.01.002

Cited by 29 publications

(11 citation statements)

References 98 publications

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“…Therefore, the choice of depot esters by our participants is expected as they fulfill the above criteria and have been in use for more than 50 years. In agreement with most expert opinions [1,6,7,14,20], the majority (46.5%) of Arab physicians started with 50 mg monthly, while 32.5% used 25 mg and 13.9% used 75 mg. Interestingly, we found a trend of using oral testosterone undecanoate in Gulf states compared to other Arab countries. Given the high resources in these countries, we suspect that this trend reflects patient preference and local availability rather than limited access to the specialist nurse team to administer injections.…”

Section: Discussionsupporting

confidence: 82%

Timing and regimen of puberty induction in children with hypogonadism: a survey on the practice in Arab countries

Hamza

Deeb

Saffar³

et al. 2020

Journal of Pediatric Endocrinology and Metabolism

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ObjectivesThere are some variations in the practice of puberty induction between different regions; however, data from Arab countries are lacking. We aimed to survey the practice of pediatric endocrinologists in Arab countries on the timing and regimen for puberty induction in girls and boys with hypogonadism.MethodsAn online questionnaire was emailed to physicians registered in the Arab Society for Paediatric Endocrinology and Diabetes.ResultsIn total, 106 replies from 17 countries were received. In non Turner syndrome (TS) girls, puberty was induced by 49.4% of participants at 12–13 years and by 32.5% at ≥14 years. Ethinyl estradiol and conjugated estrogen were the most popular preparations used (29.7 and 16.6%, respectively). Of the participants, 60% introduce progesterone either at 2–3 years after starting estrogen or following a significant breakthrough bleeding on estrogen. In girls with TS, 84.2% of participants prescribed estrogen to those aged 11 years and older (51.5% at 11–12 years) and 5.3% prescribed it to those at the prepubertal age. In boys, 57.3% of participants induce at ≥14 years, 80.6% use intramuscular testosterone and 46.5% start with 50 mg/kg/month. Human chorionic gonadotropin is more used in non-Gulf Arab countries (18.2 vs. 2.9%; p 0.036) with a trend of using oral testosterone undecanoate in Gulf states (12.2 vs. 2.0%; p 0.051).ConclusionsWe describe the approach to puberty induction in boys and girls among pediatric endocrinologists in Arab countries. The observed variation in practice would be useful in developing regional consensus guidelines on puberty induction in children with hypogonadism.

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Section: Discussionsupporting

confidence: 82%

Timing and regimen of puberty induction in children with hypogonadism: a survey on the practice in Arab countries

Hamza

Deeb

Saffar³

et al. 2020

Journal of Pediatric Endocrinology and Metabolism

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“…Zacharin used a starting dose of 0.5 mg 17β-oestradiol every second day, increasing doses over 2 years to an adult dose of 2 mg daily 12. Delemarre et al 13 and Bannink et al 14 based 17β-oestradiol dose on body weight, starting with 5 µg/kg/day and increasing to an adult dose over 2 years and 3 years, respectively.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Therefore, a pragmatic approach to the transdermal regimen was taken, ensuring the use of low doses of 17β-oestradiol, particularly in early puberty12 (personal communication with M Zacharin and T Randell, 2016).…”

Section: Proposed Regimens For Pubertal Inductionmentioning

confidence: 99%

Hormone supplementation for pubertal induction in girls

et al. 2017

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Pubertal induction in girls with ovarian insufficiency aims to mimic normal puberty, a highly complex process. Here we amalgamate the sparse global evidence and propose three options for pubertal induction regimens including oral ethinyloestradiol, and oral and transdermal 17β-oestradiol. The introduction of progestogens is discussed and the transition to hormone supplementation for adult women. The merits and disadvantages of the different options are detailed. The available evidence indicates that transdermal 17β-oestradiol has the most favourable efficacy, safety and cost profile but randomised controlled trials are urgently required to determine which regimen provides the best clinical outcomes.

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“…Independent of the underlying pathogenic mechanism, HH results in infertility. Hormone replacement therapy (HRT) is usually necessary for female HH patients not desiring fertility, so as to establish a normal menstrual cycle and stimulate development of the reproductive organs . For HH patients requiring fertility, an array of treatments is available, ranging from ovulation induction (OI) to intrauterine insemination (IUI).…”

Section: Introductionmentioning

confidence: 99%

The effects of low‐dose human chorionic gonadotropin combined with human menopausal gonadotropin protocol on women with hypogonadotropic hypogonadism undergoing ovarian stimulation for in vitro fertilization

Jiang

Kuang

2017

Clinical Endocrinology

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Pubertal induction in hypogonadism: Current approaches including use of gonadotrophins

Cited by 29 publications

References 98 publications

Timing and regimen of puberty induction in children with hypogonadism: a survey on the practice in Arab countries

Timing and regimen of puberty induction in children with hypogonadism: a survey on the practice in Arab countries

Hormone supplementation for pubertal induction in girls

The effects of low‐dose human chorionic gonadotropin combined with human menopausal gonadotropin protocol on women with hypogonadotropic hypogonadism undergoing ovarian stimulation for in vitro fertilization

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