What is the endocrine disorder in this individual?
    Is the patient’s delayed onset of puberty a primary or secondary disorder? Why?
    Why is HCG used in the treatment?
    Both FSH and HCG are needed in the treatment. Explain Why

Case Study

Parents were concerned about their 16-year-old son for the following reasons: he had no deepening of his voice, scanty pubic and axillary hair growth, absence of beard and mustache growth, small penis, poor muscular development, and psychosocial immaturity.

Laboratory evaluation indicated the following:

Serum testosterone: 100ng/dL

Sperm count: 10 million/mL semen

The following tests were performed:

Clomiphene (a nonsteroidal, weak estrogen agonist that stimulates the release of gonadotropins) 100 mg/day for seven days: 0% increase in LH (50% is normal)

Gn-RH (100 g I.V.): 0% increase in LH in twenty minutes (300% is normal)

HCG (5000 I.U., I.V.): 50% increase in plasma testosterone one to three days after injection

This person was subsequently treated with FSH at 25-75 U three times/week and HCG as described above. Sperm count and testosterone levels were both near normal after two months of treatment, and primary and secondary sex characteristics appeared.

Option #2 – Discussion Assignment:

    Compare the hormonal controls of the male reproductive cycle with the hormonal controls of the female reproductive cycle.  How are they the same?  How are they different?
    What is this condition called?
    What causes it?
    What is ectopic endometrial tissue?
    What is the rationale for using danazol, a gonadotropin inhibitor?
    Why do you think oral contraceptives could also be used as a treatment?
    Is surgical treatment an option, why?  Why not?

Case Study

A 26-year-old female complained of severe, dull, aching pain, and cramping in the lower abdomen. There were no other physical findings. A laparoscopy revealed the presence of ectopic endometrial tissue on the uterine wall and ovaries. Danazol (a synthetic androgen and inhibitor of gonadotropins), 600 mg/day, was prescribed for up to nine months to inhibit ovulation, suppress the growth of the abnormal endometrial tissue, and achieve appreciable symptomatic relief, with a 30% possibility of conception after withdrawal of the therapy.