[Functional state of the pituitary gland-ovarian system in gonadal agenesis and dysgenesis]

Functional condition of the hypophysis-gonad system with the determination of the LH and FSH level in the course of one month, of estrogens and testosterones in the blood, of estrogens in the urine, sex chromatine, kariotype, roentgenomorphology and histology of the gonads, as well as the changes in gonadotropines against the background of estrogen treatment were studied in 30 patients (in 18 with Shereshevsky-Turner's syndrome, and in 12 with pure gonad agenesis). There were differences in the state of gonadotropic activity in patients of these groups, rather similar by condition and time of the gonad affection. In Shereshevsky-Turner's syndrome gonadotropic activity was characterized by a sharp elevation of the LH and FSH level with frequent chaotic desynchronized fluctuations; in pure gonad agenesis the FSH level was elevated and subject to chaotic fluctuations; as to LH level--it was stable and within the normal limits. Shereshevsky-Turner's syndrome with pure agenesis displayed a retention of the feedback in the hypophysis-gonad system, this being indicated by reduction of the LH level against the background of estrogen therapy. The FSH content was a more informative index for the diagnosis of the gonad agenesis than the LH content. There was revealed no correlation between the kariotypes and the gonadotropin level in the patients. Estrogen therapy in the gonad agenesis and dysgenesis is required not only for feminization of the patients, but also for suppression of increased hypothalamic activity characteristic of these cases.