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THE EFFECT OF REPEATED INJECTIONS OF SYNTHETIC LH-RB ON THE RESPONSE OF PLASMA LH AND FSH IN YOUNG HYPOGONADOTROPHIC-HYPOGONADAL PATIENTS

Sixteen patients, aged 14–28 years, II with isolated gonadotropin deficiency and 5 with multiple pituitary hormone deficiency, were subjected to a course of 5 daily i.m. injections of synthetic LH-RH, 100 ug/day. Before and after this course a rapid LH-RH test (by one bolus i.v. injection of 50 ug/m2) was performed. According to the response of the plasma LH to the second LH-RH test the patients could be divided into 3 groups, Group A: 5 patients with a significantly higher response of plasma LH to the second LH-RH test; Group B: 9 patients with less significant higher response of the plasma LH to the second LH-RH test and Croup C: 2 patients with very low or no response to either stimulation used in this study. The patients in the 3 groups may represent different ethiological entities, namely that of a separate hypothalamic lesion, a “mixed” pituitary and hypothalamic lesion, and a “pure” pit. lesion, respectively. It is concluded, that the proposed procedure provides a useful tool to discriminate etiological groups in patients with abnormal gonadotrophic secretion. Recognition of tertiary hypogonadism is of practical importance for selecting those patients who can benefit from longstanding LH-RH therapy.Established Investigator of The Chief Scientist Bureau Ministry of Health