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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...

In patients with Klinefelter's syndrome (KS) serum levels of testosterone (T) were scattered within a wide range and about half were within the normal range. A similar scattering was noted in elevated levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in these patients. On the other hand, serum levels of LH, FSH and T in patients with hypogonadotropic eunuchoidism (HE) were consistently low, remaining at prepubertal levels. In patients with KS who were receiving long-term treatment with T injections serum LH and FSH remained elevated, whereas in patients with HE after the treatment LH and FSH levels were significantly lower than those before treatment. Short-term studies of serum T, LH and FSH levels after a single im T injection revealed that in patients with KS suppression of serum gonadotropins occurred only transiently and modestly, while a normal man had rapid suppression of serum LH and FSH levels to substantially undetectable levels. Long-term studies were made in ca...

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.

AN ISOLATED deficiency of pituitary gonadotropin is rare. Familial occurrence of this form of hypogonadism has been recorded infrequently and only in male siblings (1). In some reports of familial eunuchoidismit is not possible to determine whether the defect lies in the pituitary orthe gonad, since many of these cases were studied prior to the introduction of gonadotropin assays in clinical practice (2–6). We have had the opportunity to study 5 instances of hypogonadotropic eunuchoidism in two families.Three males iblings of one family and a brother and sister of another family are the subjects of this report. CASE REPORTS Family I Case 1 G. W.1 (U1 42101), a 17-year-old boy, was first seen in July 1947, with the complaints of an undescended right testis, sparse pubic and axillary hair and a high-pitched voice, lie had never needed to shave, had little libido and had experienced no erections. Previous treatment with 7,000 international units of chorionic gonadotropin had resulted in temporary increase in...

I should like to present summaries of two new cases treated with gonadotropins. The first is that of a 28-year-old married man with two children who had undergone hypophysectomy for an infarcted adenoma of the pituitary. I saw him for the first time one and a half years after this operation. He had returned to the neuro-sur-geon (Dr. Bronson Ray) because his wife desired another child. In the interim, he had been supported only by cortisone and thyroid. He had not received androgens. He complained of low libido, loss of ejaculate and of pubic, axillary and body hair. He could attain erections and orgasm after considerable stimulation. He had not experienced a spontaneous erection since the operation. It was ascertained that he had been under-active sexually during his married life and before the illness that precipitated the operation. The post-operative loss of libido therefore, had not bothered him unduly. He could not produce an ejaculate for examination in spite of erection and orgasm.