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(e.g., hypogonadotropic hypogonadism and Klinefelter syndrome with cryptor-

chidism, vanishing testes syndrome and post-orchidopexy bilateral testicular

atrophy) virilize only with androgen replacement therapy. Therefore, careful

treatment history is warranted to narrow the differential diagnosis in such a

scenario (Fig. 7.23).

ab

c

Fig. 7.23 A 20-year-old male presented with bilateral nonpalpable testes. He was well virilized
without any androgen replacement. Ultrasonography localized both the testes in the inguinal canal

7 Delayed Puberty