Urinary gonadotrophins in nine fertile eunuchs.

Abstract

ABSTRACT Urinary total hypophyseal gonadotrophins (HG), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were measured by specific bioassays in nine so-called »fertile eunuchs« with an age range of 14–27 years, mean 20.8 years. All the patients but one were extremely eunuchoid with testes of varying size but all larger than infantile testes. The excretion of androgen metabolites was low, those of gonadal origin as revealed by a dexamethasone suppression test (DXM) being extremely low. A biopsy of the testes was performed in 2 cases showing full spermatogenesis in some of the tubules and no mature Leydig cells. Five of the patients had almost normal sperm counts after treatment with testosterone or human chorionic gonadotrophin (HCG). The mean excretion of HG was 6.3 MUU/day but the individual values varied widely (95% limits 0.5–84.9) and of FSH 4.7 IU/day (95% limits 1.6–13.1) which is not significantly different from that of normal men. The mean LH was 2.1 IU/day, the 95% limits being 0.8–5.4 which is significantly lower than that of normal men (t = 5.5, P < 0.0005). Thus LH deficiency appears to be an important feature of the syndrome.