Figure 4.

Interpretation of the results of the hCG stimulation test when investigating XY DSD and pointers for consideration of prolonged hCG stimulation and ACTH stimulation. Prolonged hCG stimulation test should be considered in those cases where there is a poor testosterone response to a standard hCG stimulation test. Synacthen stimulation test should be considered in those cases who show a poor testosterone response to hCG stimulation. 46,XY children with lipoid CAH due to a StAR defect or P450scc deficiency due to CYP11A1 defect will have female genitalia and present in a salt‐losing state in the first days or weeks of life before Synacthen performed.