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Fowler PA et al. – Falling second–trimester fetal testosterone is probably due to declining maternal hCG because Leydig cell LH/hCG responsiveness remains constant. Although maternal cigarette smoking reduces fetal hCG, the ratio of inactive LHCGR isoforms is reduced and gonadotropin drive maintains testosterone production near control levels. The lower relative abundance of inactive isoforms compared with the adult testis reflects the importance of LHCGR.

Exclusive Author Commentary
Paul A. Fowler, 10/22/09

What the article shows is subtle changes in the LH/hCG receptor in the fetal testis during the second trimester. These changes are altered when the mother continues to smoke cigarettes while pregnant. Taken together with the fact that the fetal testis turns out to be relatively insensitive to LH/hCG, it is surprising that fetal testosterone production is not significantly reduced by exposure in-utero to cigarette smoke chemicals. However, in some fetuses, maternal cigarette smoking may be causing sufficient alterations in the LH/hCG - receptor - testis - testosterone sequence to contribute to observed associations between maternal cigarette smoking and an increased probability of reduced fertility in the resulting men.

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