EFFECTIVENESS AND LIMITATIONS OF THE USE OF THE GONADOTROPIN-RELEASING-HORMONE AGONIST LEUPROLIDE ACETATE IN THE DIAGNOSIS OF DELAYED PUBERTY IN MALES

In order to evaluate the effectiveness of the gonadotropin-releasing h ormone agonist leuprolide acetate in distinguishing gonadotropin defic iency from delayed puberty, a single subcutaneous dose of 20 mu g/kg o f leuprolide acetate was administered at 07.00 h to 14 patients with c onstitutionally delayed puberty and to 8 gonadotropin-deficient subjec ts, and serum gonadotropin and testosterone levels were determined at baseline and 1, 2, 3, 6, 12, and 24 h thereafter. The increase in gona dotropin and testosterone levels was significant in patients with dela yed puberty, so that the mean peak luteinizing hormone and to a lesser degree: the mean peak testosterone levels clearly differentiated norm ally delayed from gonadotropin-deficient puberty. However, when the pe ak gonadotropin and testosterone concentrations were analyzed individu ally, there was a considerable overlap between the two groups of males , limiting the usefulness of this test.