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Measurements of serum mullerian inhibiting substance in the evaluation of children with nonpalpable gonads
Lee Lab Publications
  • Mary M. Lee, University of Massachusetts Medical School
  • Patricia K. Donahoe, Massachusetts General Hospital
  • B. L. Silverman, Alkermes, Inc.
  • T. Hasegawa, Kiyose Children's Hospital
  • Yasuhiro Hasegawa, Kiyose Children's Hospital
  • M. L. Gustafson, Massachusetts General Hospital
  • Y. C. Chang
  • David T. MacLaughlin, Massachusetts General Hospital
UMMS Affiliation
Department of Pediatrics
Publication Date
Document Type
Anti-Mullerian Hormone; Child; Child, Preschool; Cryptorchidism; Diagnosis, Differential; Disorders of Sex Development; Female; *Glycoproteins; Growth Inhibitors; Humans; Infant; Infant, Newborn; Male; Mullerian Ducts; Sensitivity and Specificity; Testicular Hormones; Testis; Testosterone; Virilism

BACKGROUND: Mullerian inhibiting substance, produced constitutively by the prepubertal testes, promotes involution of the mullerian ducts during normal male sexual differentiation. In children with virilization and nonpalpable gonads, only those with testicular tissue should have detectable serum concentrations of mullerian inhibiting substance.

METHODS: We measured serum mullerian inhibiting substance in 65 children with virilization at birth and nonpalpable gonads (age at diagnosis, 2 days to 11 years) and serum testosterone in 54 of them either after the administration of human chorionic gonadotropin or during the physiologic rise in testosterone that occurs in normal infants.

RESULTS: The mean (+/-SD) serum mullerian inhibiting substance concentration in the 17 children with no testicular tissue was 0.7+/-0.5 ng per milliliter, as compared with 37.5+/-39.6 ng per milliliter in the 48 children with testes (P

CONCLUSIONS: Measurements of serum mullerian inhibiting substance can be used to determine testicular status in prepubertal children with nonpalpable gonads, thus differentiating anorchia from undescended testes in boys with bilateral cryptorchidism and serving as a measure of testicular integrity in children with intersexual anomalies.

Rights and Permissions

Copyright (1999) Massachusetts Medical Society. Reprinted with permission.

DOI of Published Version
N Engl J Med. 1997 May 22;336(21):1480-6. Link to article on publisher's site

At the time of publication, Mary Lee was not yet affiliated with the University of Massachusetts Medical School.

Related Resources
Link to Article in PubMed
PubMed ID
Citation Information
Mary M. Lee, Patricia K. Donahoe, B. L. Silverman, T. Hasegawa, et al.. "Measurements of serum mullerian inhibiting substance in the evaluation of children with nonpalpable gonads" Vol. 336 Iss. 21 (1997) ISSN: 0028-4793 (Linking)
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