Abstract
We have used pulsatile administration of gonadotrophin releasing hormone to induce puberty in 12 girls with hypogonadotrophic hypogonadism and have been able to mimic the clinical, endocrine and ultrasound changes of normal puberty. By following gonadotrophin profiles and matching them with ultrasound examination, we have been able to define the morphological (multicystic progressing to dominant follicle) appearances of the ovary that are characteristic of increasing pulsatile gonadotrophin secretion. We have established normative ultrasound data in 40 control subjects.
In our hands, pelvic ultrasound has become a non-invasive method of assessing gonadotrophin pulsatility and, using measurements of ovarian volume and of uterine size together with ovarian morphology, we can reliably distinguish simple delay of puberty from hypogonadotrophic hypogonadism and central precocious puberty from isolated premature thelarche during a single consultation. This technique offers substantial advantages for paediatric endocrine practice; it can also be used longitudinally to document response to therapeutic regimens, again without recourse to detailed endocrine studies.
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Brook, C., Adams, J. & Stanhope, R. 199 Use of Pelvic Ultrasound for the Assessment of Gonadotrophs Secretion in Disorders of Female puberty. Pediatr Res 19, 636 (1985). https://doi.org/10.1203/00006450-198506000-00219
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DOI: https://doi.org/10.1203/00006450-198506000-00219