Androgen-receptor activity in patients with false male hermaphroditism: a critical review of methods of investigation

Abstract

The paper is devoted to search for informative methods of examining patients with false male hermaphroditism which would permit assessment of androgen receptor activity in the early postnatal period and, hence, timely verify the testicular feminization syndrome and determine the desirable sex for upbringing the patient. With this aim in view specific binding of androgen receptors in the cytosol fraction of pubic skin biopsy specimens and sensitivity of androgen-dependent tissues to exogenously injected testosterone were studied in 60 patients aged 9 months to 14 years. The latter parameter was assessed by two methods: in response to parenteral depot-testosterone and to application of oily solution of testosterone propionate. Study of specific binding of androgen receptors in the cytosol fraction of pubic skin biopsy specimens was not informative for the diagnosis of the testicular feminization syndrome. The diagnostic value of investigating the sensitivity of androgen-dependent tissues to exogenous testosterone assessed by clinical signs (pigmentation of the scrotum, erection, and size of the penis) together with assessment of androgen receptor activity is satisfactory and does not depend on the mode of drug administration.