Assessing Sex Steroid Influence on Kisspeptin Responsiveness in Idiopathic Hypogonadotropic Hypogonadism.

ABSTRACT: Context:Individuals with idiopathic hypogonadotropic hypogonadism (IHH), even those with evidence of some hypothalamic reproductive endocrine activity, fail to complete puberty and fail to respond to physiologic doses of kisspeptin. Objective:This case series examined whether treatment with sex steroids could stimulate kisspeptin responsiveness in patients with IHH. Design:This was a case series. Setting:This study was conducted at an academic medical center. Participants:Seven patients with IHH were studied. Interventions:Participants, both on and off sex steroid therapy, underwent frequent blood sampling to measure LH at baseline, in response to kisspeptin and GnRH. Main Outcome Measures:The main outcome measure was LH responses to kisspeptin on and off sex steroids. Results:All participants responded to exogenous GnRH, but no participant responded to exogenous kisspeptin. Sex steroid treatment did not modify responsiveness to kisspeptin. Conclusions:The functional impairment of the GnRH neuronal network in patients with IHH, as evidenced by their inability to respond to a physiologic dose of kisspeptin, is observed in both sex steroid- deficient and sex steroid-replete states. In this case series, a normalized sex steroid milieu does not appear capable of overcoming the kisspeptin resistance of these patients.

SUBMITTER: Lippincott MF 

PROVIDER: S-EPMC6223246 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature