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Kinetics of the human chorionic gonadotropin induced steroidogenic response of the human testis 3. studies in children of the plasma levels of testosterone and human chorionic gonadotropin rationale for testicular stimulation test



Kinetics of the human chorionic gonadotropin induced steroidogenic response of the human testis 3. studies in children of the plasma levels of testosterone and human chorionic gonadotropin rationale for testicular stimulation test



Pediatric Research 14(6): 819-824



In adult men or rats, human chorionic gonadotropin [HCG] induces a rapid increase in testosterone [T] biosynthesis, followed by a steroidogenic desensitization phenomenon and a trophic effect. The recruitment of new functioning Leydig cells probably occurs parallel to the steroidogenic refractoriness of the cells when gonadotropic stimulation reaches a certain level. During pubertal development, luteinizing hormone [lutropin, LH] also induces the differentiation of existing nonsteroidogenic interstitial cells into Leydig cells. Meanwhile, circulating T levels progressively increase. Assuming that endogenous LH has the same actions as HCG, it is speculated that if a possible induction of refractoriness of the Leydig cells is present at this stage, it might modulate the testicular response to the increasing levels of LH and partially explain the relatively slow achievement of a fully active testicular secretion in humans. Little information is available regarding the time, rhythm, number and appropriate dosage of HCG for adequate testing of testicular function in human. The time course of the effect of 2, 3 or 7 HCG injections at intervals of 1, 5 and 2 days, respectively, on the plasma T levels was studied in 11 boys. The 1st injection induced a progressive and modest T rise. The 2nd given 1 day later had little additive effect, maximal values being seen 72-120 h later. In the prepubertal boys to whom several HCG injections were given, T levels reached comparable levels after 4 injections every 5 days or 7 injections every other day. Although the number of subjects studied was relatively small, these results give some rational basis for the following HCG test: 2 or 4 injections at 4 day intervals.

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