GROWTH-HORMONE THERAPY IN NONGROWTH HORMO NE-DEFICIENT GIRLS - ULTRASONOGRAPHY OF PELVIC ORGANS

The effect of growth hormone (GH) treatment on prepubertal gonads is c ontroversial especially with regard to the risk of precocious puberty. Ultrasound assessment of ovarian volume, follicle size, and uterine g rowth was performed in 20 premenarcheal girls (8.0 +/- 2.6 years) rece iving growth hormone (GH) for short stature (-2.8 +/- 0.4 SD) not rela ted to growth hormone deficiency or Turner syndrome. Mean GH dosage wa s 1.0 +/- 0.4 IU/kg/week and mean duration of treatment at evaluation was 16.3 +/- 8.9 months. All patients underwent real time ultrasonogra phy of the pelvic organs and ten subjects also had color Doppler studi es of the ovarian and uterine arteries. Ultrasound findings were simil ar to those reported in normal prepubertal girls. Mean uterine length (29.1 +/- 7.5 mm) and volume (1.23 +/- 0.86 ml) were correlated with a ge but not with dosage or duration of GH treatment. Ovarian volume was within the normal age-specific range in all patients except a 7.9 yea r old girl with substantially enlarged ovaries (4.7 ml) but no evidenc e of precocious puberty. Ovarian follicles were found in five girls; t hey measured less than 9 mm in diameter in every case except one (13 m m follicle in an 11-year-old). Blood flow in the ovarian arteries was seen on 5 of the 10 color Doppler studies and was not correlated with dosage or duration of GH treatment. Administration of GH to non-GH-def icient girls did not substantially affect the internal genital organs. It remains uncertain whether the single case of ovarian enlargement s een was related to GH treatment. However, monitoring sexual maturation may be warranted in non-GH-deficient girls given GH.