Pattern of the Response of Testosterone and Its Precursors to Human Chorionic Gonadotropin Stimulation in Relation to Age in Infants and Children*

Abstract

The pattern of response to 14-day hCG stimulation was studied in 100 apparently normal infants and children and in 2 boys with total adrenal insufficiency. Response was estimated on the levels (nanograms per dl) of testosterone (T), Δ⁴-androstenedione (Δ⁴), and 17-hydroxyprogesterone (170HP) before and after hCG. Basal levels of T, Δ⁴, and 17OHP increased significantly after 9−10 yr of age and before the onset of puberty. It would thus appear that the changes of adrenarche are also expressed by the secretion of Δ⁴ androgens. After hCG, levels of T (629 ± 218) did not vary with age in infants or prepubertal children but increased significantly at the onset of puberty (1265 ± 253). Post-hCG levels of Δ⁴ and 17OHP increased with age, but their increments (respectively, 31.1 ± 14.6 and 108.6 ± 42.2) did not vary between 2−12 yr of age. On theother hand, the rise of Δ⁴ after hCG tended to be higher in infancy and early pubescence. These data suggest that 1) testicular unresponsiveness to gonadotropins does not seem to be responsible for the postnatal decline of testicular activity; 2) during the prepubertal period there are no age-related changes inthe absolute rises of T, Δ⁴, or 170HP levels after hCG stimulation; and 3) increasing sensitivity of the testis to gonadotropic stimulation appears to be one of the very first changes occurring at the onsetof puberty.