A review of hypogonadotropic hypogonadism cases followed up in our clinic in the last decade

Abstract

Introduction: The aim of the present study was to evaluate, with this retrospective study, the patients with hypogonadotropic hypogonadism, who were followed up in our clinic in the last decade and were reviewed in terms of the incidence of the disease, diagnostic methods and differential diagnoses, treatment modalities, fertility rates, and treatment success. Methods: After a very careful differential diagnosis, 81 patients (1.5% of infertile men presenting to the outpatient clinic) were diagnosed with hypogonadotropic hypogonadism. This study only included patients diagnosed with idiopathic hypogonadotropic hypogonadism. The treatment was undertaken in two periods depending on whether or not the patients wanted to have children at that time: testosterone replacement therapy and gonadotropin therapy. To induce spermatogenesis, the patients were treated using human chorionic gonadotropin and urinary or recombinant follicle-stimulating hormone. Results: The pregnancy rates of the spouses of the patients were as follows: spontaneous 64.6% (n = 42), intrauterine insemination 12.3% (n = 8), in vitro fertilization 15.3% (n = 10), and microscopic testicular sperm extraction + intracytoplasmic sperm injection 4.6% (n = 3). Conclusion: Idiopathic hypogonadotropic hypogonadism is a rare but easily diagnosable and treatable cause of male infertility. After a long period of the treatment, almost all idiopathic hypogonadotropic hypogonadism patients can be treated with gonadotropins (human chorionic gonadotropin + follicle-stimulating hormone) in order to have children. The most important issue in the treatment is the dose of the drugs used in the treatment and the duration of the treatment. The most important result is that the required gonadotropin dose varies according to each patient. Therefore, the treatment dose and duration should be increased until patients have children.

Evaluating the Combination of Human Chorionic Gonadotropin and Clomiphene Citrate in Treatment of Male Hypogonadotropic Hypogonadism: A Prospective Study

“…The most important issue when using hCG to treat MHH and to achieve the desired outcomes was the dose and duration of treatment. 24 In the present study, the group was treated with CC at 25 mg daily and hCG at an average dose of 5000 IU administered twice weekly (i.m. or s.c.).…”

A female with isolated hypogonadotropic hypogonadism: A case report and review article

“…Secondary adrenal deficiency can be assessed by measuring morning cortisol and ACTH. Because sex steroids are necessary for growth, performing a bone age measurement should be considered in all hypogonadal patients, who may have delayed bone age compared with chronologic age [ 3 , 8 , 9 ].…”

Nonsurgical Treatment of Male Infertility: Specific Therapy

“…Spratt et al (33), reported that patients with partial/normal nocturnal LH pulses had larger testicular volume (4 mL) compared with those without LH pulses. We have reported in a currently published study (34); there are several treatment methods for patients with CHH. 1.…”

“…Compared to the literature, our series has the longest follow-up, and highest pregnancy and success rates. This can be explained by our approach that included persuading the patients to undergo long-term treatments, and increasing the dose of medicine without hesitation (34).…”