Gonadotropic Therapy in Men with Hypogonadotropic Hypogonadism

Abstract

Many therapeutic regimens, differing in dose and duration, have been employed in the treatment of hypogonadotropic hypogonadism. This study presents the results from a regimen of hCG plus hMG plus testosterone combined treatment in 15 patients affected by selective hypogonadotropic hypogonadism. The patients were homogeneous in age (16-23 years), testicular size, aspermia, absence of prior hormonal treatment, and normal karyotype. They were administered 5000 IV of hCG plus 75 IV of hMG twice a week for two months and a single dose of depo-testosterone (250 mg) in the third month. This therapeutic plan was carried out continuously for eight three-month cycles (24 months). Sexual maturation and seminal parameters were checked every six months. All the patients improved in testicular size (from 4.6 ± 1.55 ml to 13 ± 3.5 ml) and secondary sexual characteristics (penis, scrotum, pubic hair), but facial and axillary hair in most patients remained abnormal. After 24 months, all of them had ejaculations, but only two were normospermic, and seven were still azoospermic. In patients with hypogonadotropic hypogonadism treated with gonadotropins there were better results in achieving sexual maturation than in improving seminal parameters. We believe that this differential response is due to multiple factors rather than a single factor.Key words: hypogonadotropic hypogonadism, gonadotropin treatment, testosterone treatment, azoospermia, spermatogenesis, induction, sexual maturation. 1984; 5:106-110. Many years have passed since the first gonadotropins with FSH-and LH-like activity were employed as treatment for male hypogonadotropic hypogonadism, but there is not yet unanimous agreement on the conditions of their use. Such replacement therapy does not always bring satisfac- J Androl

Factors affecting spermatogenesis upon gonadotropin‐replacement therapy: a meta‐analytic study

“…The characteristics of the studies included in the meta-analysis are summarized in Table 1 (Scherman et al, 1964;Gayral et al, 1975;Burger & Baker, 1984;D'Agata et al, 1984;Gattuccio et al, 1984;Levalle et al, 1984;Abbaticchio et al, 1985;Ley & Leonard, 1985;Okuyama et al, 1986;Burris et al, 1988b;Liu et al, 1988a;Burger et al, 1990;Saal et al, 1991;Schopohl et al, 1991;Vicari et al, 1992;Lenzi et al, 1993;Schaison et al, 1993;Kung et al, 1994;Kliesch et al, 1994;Kirk et al, 1994;Fuse et al, 1996;Burgu es & Calder on, 1997;European Metrodin HP Study Group, 1998;Tachiki et al, 1998;Giagulli, 1999;Carani et al, 1999;Liu et al, 1999;Bouloux et al, 2002Bouloux et al, , 2003Miyagawa et al, 2005;Zorn et al, 2005;Bakircioglu et al, 2007;Homayoun et al, 2008;Efesoy et al, 2009;Matsumoto et al, 2009;Oldereid et al, 2010;Warne et al, 2009;Sinisi et al, 2010;Milsom et al, 2012;…”