The gonadotropin response to synthetic gonadotropin releasing factor in patients with testicular cancer.

The response of LH and FSH to synthetic gonadotropin releasing factor (GRF) was investigated in 19 patients with malignant germ cell cancers of the testicle prior to radical orchiectomy. The study showed: 1. Patients with circulating beta-HCG presented with increased plasma levels of oestradiol. Base line FSH and response to GRF were significantly decreased. 2. In patients without detectable beta-HCG plasma concentrations of oestradiol and testosterone were within the normal ranges as compared to healthy age matched controls. Base line levels of FSH and LH were increased and an exaggerated response to GRF was observed. From the results of this study it can be concluded that hypergonadotropic dysfunction of pituitary-gonadal axis exists in patients with testicular cancer of germ cell origin. Beta-HCG production by tumour tissue results in hyperoestrogenism and interferes with the pituitary-gonadal axis in terms of inhibition of pituitary gonadotropin release.