Endocrine Abstracts

A 33-year-old lady was referred to the endocrinology clinic with mild hyperprolactinaemia on the background of having missed a single period, with a raised testosterone of 4.1 nmol/l (0–2). She had no other medical problems. Her menstrual cycles normalised by the time she attended clinic. She had no galactorrhoea, visual disturbance or features of hyperandrogenism. Her BMI was normal and she was normotensive. Blood tests revealed mild hyperprolactinaemia of 709 nU/l (100&...

Case: A 19-year-old British-Asian man presented with a two-year history of gynaecomastia. He had no other symptoms of hypogonadism. On examination, BMI was 28 kg/m2 and he had post-pubertal-sized testes (20 ml) with normal secondary sexual characteristics. Hypogonadism was confirmed by two morning fasting total testosterone levels of 4.7 and 5.2 (RR 9.2–31.6 nmol/l). Haemoglobin was normal (152 g/l) and serum oestradiol was <100 pmol/l. He had inappropriate...

Background: During IVF treatment, a pharmacological dose of recombinant FSH (rFSH) is used to induce multi-follicular growth (controlled ovarian stimulation; COS). An insufficient dose of rFSH negatively impacts the number of oocytes retrieved, whereas an excessive dose risks the potentially life-threatening complication ‘ovarian hyperstimulation syndrome’. Hence, appropriate rFSH dosing is regarded as a key treatment decision affecting both the success and safety of...

Background: Women with hypothalamic amenorrhoea (HA) have reduced LH pulsatility causing amenorrhea and infertility. Estrogen supplementation provides symptomatic relief for women with HA, but does not restore the pulsatile pattern of LH secretion which necessary for fertility. Kisspeptin-54 is a recently identified hormone, which potently stimulates GNRH secretion within the hypothalamus. The effect of exogenous kisspeptin-54 administration on LH pulsatility in women with HA ...

Background: The peptide hormone kisspeptin is essential for human reproduction, acting on the hypothalamus to stimulate GnRH secretion. Kisspeptin is emerging as a possible novel therapeutic for women with infertility. However animal studies suggest that kisspeptin may also stimulate pituitary secretion of GH, prolactin, and TSH, which has important implications for its safety. There has been no previous study investigating kisspeptin effects on non-reproductive hormones in hu...

Background: The KISS1 gene, is a critical regulator of normal reproductive function. In humans, KISS1 deletion results in a failure to go through puberty while activating mutations result in central precocious puberty. Administration of kisspeptin induces ovulation in rodents and sheep. However chronic exposure to exogenous kisspeptin-54 leads to profound tachyphylaxis in women with hypothalamic amenorrhoea. It is not known whether exogenous kisspeptin can alter the m...

Introduction: Kisspeptin-54 is a recently identified hormone, which potently stimulates GnRH secretion within the hypothalamus. Women with hypothalamic amenorrhoea (HA, hypogonadotrophic hypogonadism associated with low body weight) have reduced LH pulsatility causing amenorrhea and infertility. We have previously demonstrated that exogenous administration of kisspeptin-54 acutely stimulates gonadotrophin secretion in women with HA. However, it is not known whether exogenous k...

Background: Genetic deficiency of the hypothalamic hormone kisspeptin, lead to pubertal failure and infertility. Kisspeptin is therefore a critical hypothalamic activator of reproduction. Kisspeptin-10 stimulates gonadotrophin release in both male and female rodents. However few studies have investigated the effects of kisspeptin-10 on gonadotrophin release in humans, and none have investigated its effects in women. If kisspeptin is to be useful for treating reproductive disea...

Background: Kisspeptin is a novel hypothalamic hormone with powerful stimulatory effects on the hypothalamo-pituitary–gonadal (HPG) axis. Inactivating mutations in the kisspeptin receptor lead to pubertal failure. We have previously demonstrated that injection of kisspeptin-54 stimulates LH release in healthy men and women. Recent studies in animals suggest that endogenous kisspeptin may be involved in stimulating the GnRH pulse generator. Determining whether exogenous ad...

Background: Infertility is a common problem and the number of couples receiving assisted reproductive treatment (ART) is increasing. Using GnRH agonists (GnRHa) to trigger oocyte maturation has been shown to reduce risk of ovarian hyperstimulation syndrome (OHSS), a common complication of IVF, compared to the more traditional use of human chorionic gonadotropin (hCG). Kisspeptin has recently been shown to be a safe trigger of oocyte maturation in women at high risk of OHSS. Ki...