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Hypothalamic–Pituitary–Gonadal (HPG) Axis Differentials

by Carlo Raj, MD
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    We have an important table here. I really need you to know about the HPG Axis: H, hypothalamus; P, pituitary; G, gonadotrophic. Are we clear? The table here is going to show us testosterone and a couple of other parameters in which it’s going to move left or right. On the X axis represents age of your male. Let’s first focus upon the green line. That green line represents testosterone. Fetus, let me ask you a few questions embryologically. Are you ready? You can do this. We have testosterone. This testosterone is going to help the fetus obviously turn into a male. Genotypically, everything is great. Normal by the way, normal? Important to pay attention here because I will give you a table coming up in which I’ll walk you through differentials such as androgen and sensitivity syndrome. Then in female, things like Müllerian agenesis will become important. Pay attention. So here, everything is perfectly normal. Testosterone is being properly supplied to the fetus. We have a genotype of XY. The Y, the Y chromosome is going to give the male two things by default, by default. The Y is going to give the fetus, the male fetus the proper gonad. What’s a proper male gonad? Testis, that’s what the Y chromosome is going to give your male. Where is it located? Well whatever. Up in the abdomen and then we talked about the migration. Next, what else is that Y going to give you? Obviously the Y is not going to give you vagina. The Y is not going to give you the uterus. The Y wants to get rid of all that or not or regress, correct? But remember, all of us in the fetus, we were all ladies. We were all unisex. We’re all females. We...

    About the Lecture

    The lecture Hypothalamic–Pituitary–Gonadal (HPG) Axis Differentials by Carlo Raj, MD is from the course Reproductive Hormone Disorders.


    Included Quiz Questions

    1. FSH is under the negative feedback of inhibin and is not affected.
    2. Causes infertility due to Leydig cell atrophy
    3. LH is low
    4. Testosterone is high
    5. Commonly seen in athletes
    1. Inhibin is secreted by Leydig cells.
    2. Inhibin infusion will cause decrease spermatogenesis.
    3. Inhibin infusion will cause decrease FSH.
    4. Inhibin infusion is experimental.
    5. FSH is high in patients with Inhibin Deficiency due to testicular failure.

    Author of lecture Hypothalamic–Pituitary–Gonadal (HPG) Axis Differentials

     Carlo Raj, MD

    Carlo Raj, MD


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