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Zusammenfassung Bei einem Patienten mit hypogonadotropem Eunuchoidismus wurde der Clomiphentest zur Erfassung der hypothalamo-hypophysaren Funktionsreserve durchgefuhrt. Die Bestimmung der FSH/LH-Ausscheidung erfolgte mit neuen immunochemischen Testen im unkonzentrierten Urin. Wahrend und nach der Gabe von 200 mg Clomiphencitrat / die uber 13 Tage wurde kein signifikanter Anstieg der Gonadotropinausscheidung beobachtet. Ablauf und Nutzlichkeit des Clomiphentests in der Andrologie werden ausfuhrlich diskutiert. Abstract Clomiphene citrate stimulation of pituitary gonadotropin reserve was performed in a male with hypogonadotropic eunuchoidism. For evaluation, new immunochemical tests for simple determination of FSH and LH in unconcentrated urine were applied. No increase of FSH/LH-excretion was observed during or after administration of 200 mg clomiphene citrate / die for 13 days. Set-up and possible usefulness of the clomiphene test in andrology are discussed in detail. Resume Un test au clomiphene fut pratique chez un malade atteint d'eunuchoidisme hypogonado-tropique en vue de determiner la reserve fonctionnelle hypothalamo-hypophysaire. La determination de l'excretion de FSH et de LH fut executee a l'aide de nouveaux tests immunochimiques. Aucune elevation significative de l'excretion des gonadotropines fut observee pendant et apres 13 jours d'administration de citrate de clomiphene. L'application et l'utilite du test au clomiphene en andrologie furent amplement discutees.

THE therapeutic efficacy of most of the available gonadotropic hormone preparations is limited by the rapid development of neutralizing substances generally termed antihormones. Pregnant mare's serum is particularly prone to call forth the development of these antihormones, thereby restricting the possible usefulness of this therapeutic agent to brief periods. On the other hand, there are available preparations of the chorionic gonadotropic hormone from human pregnancy urine which have appeared to be singularly free of this complicating reaction in man. However, it has been possible to produce neutralizing substances against this human chorionic gonadotropic hormone in various species of animals. This subject has been reviewed by Leathern (5) and Thompson (8). Despite the lack of demonstrable titers of antihormone against chorionic gonadotropic hormone in man, speculation about its existence has been extensive. A pregnancy test based on the concept that in women antihormones would regularly develop agains...

Immature-type Sertoli cells in the testes of idiopathic hypogonadotropic eunuchoidism (17-30 years of age) had no specialized junctions. The specialized Sertoli junctions that blocked the penetration of lanthanum were formed six months to two years after hCG treatment (5000 IU twice a week) in patients of hypogonadotropic eunuchoidism. In two patients with postpubertal pituitary failure (one had a ectopic pinealoma, irradiated one year ago, and the other had a pituitary adenoma, hypophysectomized four years ago), the ultrastructural integrity of these Sertoli junctions was maintained. Therefore, it may be suggested that the development of the blood-testis barrier is dependent on gonadotropins, but the maintenance of the blood-testis barrier is not.

It is described to which extent the fertility potential in the following six groups of patients living in sterile marriages is lowered: in 298 patients with Klinefelter's syndrome, 38 hypogonadotropic eunuchoids, 216 bilateral and 258 unilateral cryptorchids, in 500 men with testicular hypoplasia in whom the long axis of both testicles had always been shorter than 34 mm, and in 109 men with a varicocele. The opinion is expressed that the above mentioned pathologic states of the genital organs are of primary nature and occurred at various stages of somato-sexual development.