HCG therapy in azoospermic men with lower or borderline testosterone levels and the prognostic value of Y‐deletion analysis in its outcome

Abstract

The purpose of this study was to investigate the efficacy of hCG therapy in hypogonadotropic hypogonadic (HH) azoospermic males along with dissecting the prognostic value of Y-deletion analysis in these patients. Fifty-eight azoospermic infertile males with diminished testosterone levels (≤400 ng/dl) and hypogonadism symptoms were subjected to human chorionic gonadotropin (hCG) therapy, and Y-deletion analysis was undertaken. Post-treatment, 43% (25/58) patients showed improvement in sperm count with 8.6% (5/58) turning severe oligozoospermic, 24.14% (14/58) patients turning oligozoospermic and 10.54% (6/58) turning normozoospermic. Among responders, the mean sperm concentration was 8.47 ± 13.16 million/ml, sperm count was 17.05 ± 26.17 million, sperm motility was 52.59% ± 25.09% and sperm progressive motility was 26.91% ± 20.51%. Seventeen out of 25 (68%) responders and 11/33 (33%) nonresponders showed an improvement in libido post-therapy. A Y-deletion was observed in 8% (2/25) responders and in 39.39% (13 out of 33) nonresponders.The Y-deletions were more often found in nonresponders in comparison with the responders (Fisher's exact probability test, p = .007, one tailed). We conclude that hCG therapy in hypogonadotropic azoospermic males is effective in improving andrological parameters and sperm production and that Y-chromosome deletion analysis has prognostic significance in predicting the success of hCG therapy.

The impact of male factors and their correct and early diagnosis in the infertile couple's pathway: 2021 perspectives

“…However, the most effective therapeutic scheme in terms of sperm parameters improvement and pregnancy rate is still far to be identified. Despite a physiological spermatogenesis requires a synergic action of LH and FSH, several authors highlighted a sperm number increase in HH men using only hCG [ 86 , 89 , 111 ]. Thus, is it conceivable that the FSH action is redundant?…”

Human chorionic gonadotropin therapy in hypogonadic severe-oligozoospermic men and its effect on semen parameters

“…Various protocols have been used in men with hypogonadism to induce and maintain spermatogenesis. Monotherapy of hCG or in combination with human menopausal gonadotropin can be given to azoospermic males for 3–6 months to achieve spermatogenic restoration, as shown by the presence or increase of spermatozoa in the ejaculate [ 16 ]. In our case, monotherapy of 250 μg of hCG was successfully used to increase the sperm concentration in severely oligozoospermic men.…”