Anti-Müllerian hormone and letrozole levels in boys with constitutional delay of growth and puberty treated with letrozole or testosterone

Abstract STUDY QUESTION Does treatment of constitutional delay of growth and puberty (CDGP) in boys with aromatase inhibitor letrozole (Lz) or conventional low-dose testosterone (T) have differing effects on developing seminiferous epithelium? SUMMARY ANSWER Anti-Müllerian hormone (AMH) declined sim...

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Published in:Human reproduction (Oxford) 2020-02, Vol.35 (2), p.257-264
Main Authors: Kohva, E, Varimo, T, Huopio, H, Tenhola, S, Voutilainen, R, Toppari, J, Miettinen, P J, Vaaralahti, K, Viinamäki, J, Backman, J T, Hero, M, Raivio, T
Format: Article
Language:English
Subjects:
Adolescent
Andrology
Anti-Mullerian Hormone - blood
Biomarkers - blood
Child
Female
Finland
Growth Disorders - blood
Growth Disorders - drug therapy
Humans
Hypogonadism - blood
Inhibins - blood
Letrozole - administration & dosage
Letrozole - blood
Letrozole - therapeutic use
Male
Original
Puberty, Delayed - blood
Puberty, Delayed - drug therapy
Testosterone - administration & dosage
Testosterone - therapeutic use
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Summary:Abstract STUDY QUESTION Does treatment of constitutional delay of growth and puberty (CDGP) in boys with aromatase inhibitor letrozole (Lz) or conventional low-dose testosterone (T) have differing effects on developing seminiferous epithelium? SUMMARY ANSWER Anti-Müllerian hormone (AMH) declined similarly in both treatment groups, and the two Sertoli cell-derived markers (AMH and inhibin B (iB)) exhibited differing responses to changes in gonadotrophin milieu. WHAT IS KNOWN ALREADY Boys with CDGP may benefit from puberty-inducing medication. Peroral Lz activates gonadotrophin secretion, whereas intramuscular low-dose T may transiently suppress gonadotrophins and iB. STUDY DESIGN, SIZE, DURATION Sera of 28 boys with CDGP who participated in a randomised, controlled, open-label trial at four paediatric centres in Finland between August 2013 and January 2017 were analysed. The patients were randomly assigned to receive either Lz (2.5 mg/day) (n = 15) or T (1 mg/kg/month) (n = 13) for 6 months. PARTICIPANTS/MATERIALS, SETTING, METHODS The 28 patients were at least 14 years of age, showed first signs of puberty, wanted medical attention for CDGP and were evaluated at 0, 3, 6 and 12 months of visits. AMH levels were measured with an electrochemiluminescence immunoassay and Lz levels with liquid chromatography coupled with tandem mass spectrometry. MAIN RESULTS AND THE ROLE OF CHANCE AMH levels decreased in both treatment groups during the 12-month follow-up (P 
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/dez231