Abstract
Eight patients (3 F, 5 M) have been treated with low dose pulsatile GnRH to induce puberty using two different dose regimens. In 7 the hypogonadotrophic hypogonadism was idiopathic and in one followed surgery and radiotherapy for a posterior fossa astrocytoma. Mean age at commencement of treatment was 16.3 years (14.3 to 19.7).
One girl and one boy were treated continuously throughout 24 hr with GnRH 15 μg subcutaneously every 90 mins. Ovarian changes were detected by ultrasound after one week and a 'multicystic' appearance after 8 weeks. Breast development to Stage 2 was seen at 4 months but failed to progress due to 'down regulation'. Plasma testosterone in the boy increased from <1 to 23 nmol/L in 9 months when the genetalia were Stage 5 and a growth spurt had occured.
Six patients have been treated with nocturnal pulsatile GnRH 2 μg subcutaneously every 90 minutes for 6 months. Two girls had a detectable ovarian ultrasound response in one week and a progression in pubertal staging by 3 months. Four boys have shown a diurnal variation in plasma testosterone from evening values <1 nmol/L to morning values >4 nmol/L. Testicular enlargement occured before 3 months of therapy. All patients have been monitored by serial nocturnal plasma profiles of gonadotrophins, prolactin, growth hormone and testosterone or oestradiol.
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Stanhope, R., Adams, J., Jacobs, H. et al. The induction of puberty by low dose pulsatile GnRH. Pediatr Res 18, 1210 (1984). https://doi.org/10.1203/00006450-198411000-00054
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DOI: https://doi.org/10.1203/00006450-198411000-00054