Isolated pituitary gonadotrophin deficiency: gonadotrophin secretion after synthetic luteinizing hormone and follicle stimulation hormone-releasing hormone

The responses of serum immunoreactive luteinizing hormone (LH) and follicle stimulating hormone (FSH) after intravenous injection of 100 mug of synthetic LH/FSH-RH have been studied in 14 patients with the syndrome of isolated pituitary gonadotrophin deficiency. Nine of the patients showed a rise of both hormones, two a small rise of FSH only, and three were unresponsive. In two of the unresponsive patients injection of a 500-mug dose produced a small rise of LH only. Of the patients who responded, four had LH and FSH responses within the normal adult range, while in the others the responses were smaller and delayed. It is suggested that this syndrome is due to a lack of the hypothalamic-releasing hormone itself, rather than to a pituitary deficiency. However, repeat assessment after prolonged administration of the releasing hormone will be necessary before a pituitary disorder can be excluded in all patients. The synthetic LH/FSH-RH, preferably as a depot preparation, may provide a means of treating these patients to induce the development of puberty and subsequent fertility.