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- Title
The Effect of the Testis on the Ovary: Structure-Function Relationships in a Neonate with a Unilateral Ovotestis (Ovotesticular Disorder of Sex Development).
- Authors
Greeley, Siri Atma W.; Littlejohn, Elizabeth; Husain, Aliya N.; Waggoner, Darrel; Gundeti, Mohan; Rosenfield, Robert L.
- Abstract
Aims: To evaluate gonadal function in a newborn with suspected ovotesticular disorder of sex development (DSD). Methods: Gonadal function was evaluated at baseline and after gonadotropin-releasing hormone agonist (GnRHag) stimulation testing. Results: A full-term 46,XX neonate with genital ambiguity produced serum testosterone and anti-Müllerian hormone (AMH) levels appropriate for males within days, while serum estradiol remained prepubertal, both spontaneously and in response to GnRHag stimulation testing. Ovotesticular DSD was diagnosed at laparoscopy: the left gonad was an ovotestis and the right gonad an ovary arrested at the primordial follicle stage of development. Mosaicism for an isochromosome of the Y short arm in 6--18% ofgonadal cells was demonstrated. After ovotestis removal at 3 weeks of age, serum AMH became low within a month, but the elevated testosterone was slow to resolve, apparently from ovarian androgenic hyperfunction coincident with ovarian estrogenic hyperfunction and an adult degree of ovarian development. Ovarian morphology and function gradually normalized as neonatal minipuberty waned. Conclusions: In a neonate with genital ambiguity due to ovotesticular DSD, testicular AMH and testosterone production respectively appear to account for the initial arrest of ovarian development and subsequent rapid hyperfunction of the contralateral ovary after ovotestis removal.
- Subjects
SEX differentiation disorders; LUTEINIZING hormone releasing hormone
- Publication
Hormone Research in Paediatrics, 2017, Vol 87, Issue 3, p1
- ISSN
1663-2818
- Publication type
Article
- DOI
10.1159/000455142