Parents were concerned about their 16 year old son for the following reasons: he had no deepening of his voice, scanty pubic and axillary hair growth, absence of beard and mustache growth, small penis, poor muscular development, and psycho-social immaturity.

Clinical evaluation indicated the following:

serum testosterone 100 ng/dl…………..…........normal 437-707 ng/dL

sperm count 10 mil/mL semen…….........normal 50-150 million/mL

karyotype normal

The following tests were performed. Administration of:

1) Clomiphene citrate (a nonsteroidal stimulant of the gonadotropins) 100 mg/day for 7 days:

0 % increase in LH (50% is normal)

2) GnRH 100 mg IV: 0% increase in LH in 20 mins (300% is normal)

3) hCG (5000 IU IV): 50% increase in plasma testosterone 1 to 3 days after injection

This person was subsequently treated with FSH at 25-75U 3 times/wk and hCG as described above.

1. Define the terms in bold.

2. What is the endocrine disorder of this individual?

3. Why is hCG used in the treatment?

4. Why would FSH and HCG both be needed in the treatment?

5. Before treatment where is his testosterone coming from?

6. After treatment for a few weeks, what would expect testosterone levels to be? Why?

7. Where is the additional testosterone coming from? Which of the administered hormones is involved? How?

8. After treatment for a few weeks, what would you expect sperm production to be? Why? Which of the administered hormones is involved? How?

9. What sort of external body changes would you notice?

10. What sort of psycho-social changes would you notice