Undescended Teste vs Androgen Insensitivity - FSH, LH

[usmleq]

In UWSA1 there is a guy with androgen insensitivity, it says testosterone and LH levels will be high and FSH will be normal. He also has bilateral undescended testes.

In a different question there is a guy with one undescended test and he has high FSH because the sertoli cells in the undescended teste don't function to make inhibin because it is too warm.

The guy with androgen insensitivity should have high FSH also since he has undescended testes, right?

Is this an oversight by UW or am I missing something.

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[Phloston]

In UWSA1 there is a guy with androgen insensitivity, it says testosterone and LH levels will be high and FSH will be normal. He also has bilateral undescended testes.

In a different question there is a guy with one undescended test and he has high FSH because the sertoli cells in the undescended teste don't function to make inhibin because it is too warm.

The guy with androgen insensitivity should have high FSH also since he has undescended testes, right?

Is this an oversight by UW or am I missing something.

That's interesting. Although the mechanism for FSH elevation in the latter case is plausible and understandable, I've never actually heard of that before as an occurrence associated with cryptorchidism.

If I were to make a guess, it would be that the androgen insensitivity at the hypothalamic-pituitary axis, in the former case, leads not only to augmentation of LH levels, but also to that of GnRH and the LH/FSH ratio and pulse frequency, thereby reducing FSH on a relative scale, irrespective of a potential declivity of the inhibin-A level.

In the latter case, reduced inhibin-A alone would increase FSH, given that testosterone levels are not affected. If testosterone were concomitantly reduced, then I'd expect findings similar to those of the former case.

Hope that helps,

 

[GTP]

That's interesting. Although the mechanism for FSH elevation in the latter case is plausible and understandable, I've never actually heard of that before as an occurrence associated with cryptorchidism.

If I were to make a guess, it would be that the androgen insensitivity at the hypothalamic-pituitary axis, in the former case, leads not only to augmentation of LH levels, but also to that of GnRH and the LH/FSH ratio and pulse frequency, thereby reducing FSH on a relative scale, irrespective of a potential declivity of the inhibin-A level.

In the latter case, reduced inhibin-A alone would increase FSH, given that testosterone levels are not affected. If testosterone were concomitantly reduced, then I'd expect findings similar to those of the former case.

Hope that helps,

I'm so screwed