Optimal treatment for spermatogenesis in male patients with hypogonadotropic hypogonadism

Medicine (Baltimore). 2019 Aug;98(31):e16616. doi: 10.1097/MD.0000000000016616.

Abstract

Background: To compare the efficacies of gonadotropin-releasing hormone (GnRH) pulse subcutaneous infusion with combined human chorionic gonadotropin and human menopausal gonadotropin (HCG/HMG) intramuscular injection have been performed to treat male hypogonadotropic hypogonadism (HH) spermatogenesis.

Methods: In total, 220 idiopathic/isolated HH patients were divided into the GnRH pulse therapy and HCG/HMG combined treatment groups (n = 103 and n = 117, respectively). The luteinizing hormone and follicle-stimulating hormone levels were monitored in the groups for the 1st week and monthly, as were the serum total testosterone level, testicular volume and spermatogenesis rate in monthly follow-up sessions.

Results: In the GnRH group and HCG/HMG group, the testosterone level and testicular volume at the 6-month follow-up session were significantly higher than were those before treatment. There were 62 patients (62/117, 52.99%) in the GnRH group and 26 patients in the HCG/HMG (26/103, 25.24%) group who produced sperm following treatment. The GnRH group (6.2 ± 3.8 months) had a shorter sperm initial time than did the HCG/HMG group (10.9 ± 3.5 months). The testosterone levels in the GnRH and HCG/HMG groups were 9.8 ± 3.3 nmol/L and 14.8 ± 8.8 nmol/L, respectively.

Conclusion: The GnRH pulse subcutaneous infusion successfully treated male patients with HH, leading to earlier sperm production than that in the HCG/HMG-treated patients. GnRH pulse subcutaneous infusion is a preferred method.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Chorionic Gonadotropin / therapeutic use
  • Drug Administration Routes
  • Drug Administration Schedule
  • Drug Combinations
  • Follicle Stimulating Hormone / blood
  • Gonadotropin-Releasing Hormone / administration & dosage
  • Gonadotropin-Releasing Hormone / therapeutic use*
  • Humans
  • Hypogonadism / drug therapy*
  • Infusion Pumps
  • Luteinizing Hormone / blood
  • Male
  • Menotropins / therapeutic use
  • Reproductive Control Agents / administration & dosage
  • Reproductive Control Agents / therapeutic use*
  • Spermatogenesis / drug effects*
  • Testosterone / blood
  • Young Adult

Substances

  • Chorionic Gonadotropin
  • Drug Combinations
  • Reproductive Control Agents
  • Gonadotropin-Releasing Hormone
  • Testosterone
  • Menotropins
  • Luteinizing Hormone
  • Follicle Stimulating Hormone