The physiological significance of pulsatile LHRH secretion in man: gonadotrophin responses to physiological doses of pulsatile versus continuous LHRH administration

This study tested whether pulsatile LHRH stimulation of the pituitary is required for normal gonadotrophin secretion in man. Four men with idiopathic hypogonadotrophic hypogonadism (IHH) and presumed endogenous LHRH deficiency were taken off all hormonal replacement for 5-6 weeks, then 5 micrograms LHRH was administered every 2 h for 1 week in order to prime pituitary gonadotrophin responsiveness. A physiological dose of LHRH (10 micrograms every 2 h) was then administered in both pulsatile and continuous regimens, in varying order, to each man. Pulsatile LHRH was capable of stimulating LH (as measured by bioassay) and FSH secretion, while continuous administration of LHRH was not. Serum LH, measured by RIA and bioassay, and FSH and free alpha-subunit levels, measured by RIA, increased significantly (P less than 0.05) over pretreatment levels during pulsatile LHRH administration. In contrast, bioactive LH and immunoactive FSH did not change significantly compared to pretreatment values during continuous infusion of the same total LHRH dose, although immunoactive LH and free alpha-subunit levels did increase significantly (P less than 0.05). The ratio of LH bioactivity to immunoactivity was significantly lower during the continuous compared to pulsatile LHRH regimen (P less than 0.001). Similar serum LHRH levels were achieved during pulsatile and continuous infusions. Serum testosterone and oestradiol levels did not increase significantly from pretreatment levels during either regimen of LHRH administration. It is concluded that a pulsatile LHRH signal pattern is essential for normal pituitary gonadotrophin secretion in men with IHH. Continuous infusion of a physiological dose of LHRH, which produced serum LHRH levels which were indistinguishable from those found during pulsatile administration, failed to stimulate FSH or bioactive LH secretion.     

Biologically Active Luteinizing Hormone (LH) in Klinefelter''s Syndrome: Response to Gonadotropin-Releasing Hormone (GnRH) and Effects of Testosterone Undecanoate

Basal and gonadotropin-releasing hormone (GnRH)-stimulated levels of biologically active and immunoreactive LH (bLH and iLH) were measured in six patients with Klinefelter's syndrome (KS) (mean age 24.7 years). In the same patients the diurnal rhythm of serum testosterone (T) was investigated (morning values vs. evening values). The results were compared with those obtained in ten normal young men (mean age 29.3 years). Moreover, in one patient with KS we studied the effects of testosterone undecanoate (TU) administration on bLH and iLH basal levels. A sensitive "in vitro" bioassay, based on T production by mechanically dispersed mouse Leydig cells, was employed to assess LH bioactivity. Levels of iLH and T were determined by a double antibody radio-immunoassay technique. Mean basal levels of bLH and iLH were significantly higher (p less than 0.001) in the Klinefelter patients than in normal men, whereas the mean bioactivity to immunoreactivity (b/i) ratio of LH was similar in the two groups. The mean morning T concentration was significantly higher in normal men (p less than 0.001) than in the Klinefelter group. The diurnal T rhythm was lost in the patients with KS. In the Klinefelter patients the relative maximum response of bLH to GnRH (bLH delta%) was significantly lower (p less than 0.02) than in the control men. In addition, the b/i ratio of GnRH-stimulated Lh decreased significantly (p less than 0.05) from basal values in the Klinefelter patients, whereas it remained unchanged in the control group. In the patient with KS treated with androgen replacement therapy, TU decreased iLH serum levels more than bLH concentrations, thereby increasing the b/i ratio of basally secreted LH.     

Chemical Constituents of Human Seminal Plasma: Relationship to Fertility/Chemische Bestandteile des menschlichen Spermaplasmas: Beziehungen zur Fertilität

Eighteen different chemical constituents of seminal plasma from 52 patients in an in vitro fertilization (IVF) program were quantitated. The ejaculates were divided into "fertile" and "infertile" groups depending on whether the spermatozoa did or did not fertilize oocytes. Glycerylphosphorylcholine showed a significant difference between the two groups and was also significantly correlated with fertility, suggesting that GPC may influence the fertilizing ability of the spermatozoa. No such differences/correlations were found for the other constituents although a number of these components were lowest in the "infertile" group. In no case was the correlations between a seminal constituents and fertilization high enough to predict whether an ejaculate is fertile or infertile.