Endocrine Abstracts (2010) 22 P543

Serum INSL3 dynamics in young men with congenital hypogonadotropic hypogonadism treated with gonadotropins

Giuseppe Bellastella, Dario Esposito, Luigi Maione, Daniela Visconti, Vincenzo Palumbo, Annamaria De Bellis, Antonio Bellastella & Antonio Agostino Sinisi


Department of Clinical and Experimental Medicine and Surgery, Second University of Napoli, Napoli, Italy.


Insulin-like factor 3 (INSL3) is produced by Leydig cells. In boys, the levels of INSL3 rise at pubertal stage P2 and further increase throughout puberty in close correlation with T and LH concentrations. In men with hypogonadotropic hypogonadism (HH) INSL3 levels have been found very low and increased after short-term hCG treatment. Whether FSH plays a role in regulating INSL3 secretion is questioned. Aim of this study was to evaluate serum INSL3 levels during long-term hCG and rFH+hCG replacement therapy in men with HH.

Methods: Eighteen men (18–24 years old) with never treated prepubertal-onset HH received 2000 IU i.m. hCG to induce puberty. After 6–12 months, they were treated with hCG plus rFSH (75 IU) twice a week. Serum INSL3 levels were assessed at diagnosis and every 3 months throughout gonadotropin replacement therapy.

Results: INSL3 levels, low at diagnosis (33.3±5.4 pg/ml), significantly rose to 453±53.1 (P<0.001) after 6–12 months of hCG alone, when near all patients reached pubertal stage P3. A further significant increase was observed after 3 and 6 months of rFSH+hCG administration (532.5±56.3 and 601.2±58.1, respectively, P<0.04–0.07).

Conclusions: INSL3 concentration increases progressively under hCG therapy paralleling the pubertal changes induced in men with HH. A further rise of INSL3 levels during the combined rFSH and hCG administration suggest a positive effect of FSH on Leydig cell secretion.

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