Prolonged pulsatile LRH treatment in different frequency schedules in a hypogonadotropic male

A 22 years old male patient with a pubertal arrest of unknown origin at P4, G3 received LRH in three different schedules, each lasting for four weeks. 8 times per day 20 micrograms LRH iv, 16 times per day 20 micrograms LRH iv, 32 times per day 20 micrograms LRH iv. During the first period the low FSH levels increased into the normal adult range, while LH remained at the low level, a change also observed in early puberty. Testosterone increased to low normal adult values. In the second period LH as well as testosterone increased to normal adult values and in the third period LH, FSH as well as testosterone increased into the high normal range. There was no evidence of desensitization of the gonadotrophic cells during the third period. From these data we suggest that: 1. LRH treatment in a frequency higher than physiologic, as observed in adult men, does not result necessarily in desensitization of the gonadotrophic cells and 2. the change in gonadotropin secretion in early puberty may be the result of an increased LRH stimulation in a frequency lower than observed in adults.