Application of hormonal treatment in hypogonadotropic hypogonadism: more than ten years experience.

Abstract

OBJECTIVE:

To demonstrate the efficacy of hormone treatment on the patients with hypogonadotropic hypogonadism (HH), we summarized our more than 10 years experience.

MATERIALS AND METHODS:

A total of 242 male patients (age range 15-52 years old) with HH including two Kallmann syndrome treated at the andrology outpatient clinics of university hospital in the past 10 years were reviewed retrospectively. The patients were divided into three groups based on the different treatment strategy. There were 84 patients treated with human chorionic gonadotropin (hCG) (group 1, hCG treatment group), 74 patients treated with hCG plus human menopause gonadotropin (hMG) (group 2, hCG + hMG treatment group), and 84 patients treated with testosterone (group 3, T treatment group). Sex characteristics, testicular volume, and sperm production were determined before and after the treatments. The therapeutic effects in the three groups were analyzed statistically.

RESULTS:

In total, 42 patients of group 1 (50.0%) and 56 of group 2 (75.7%) had their testicular volumes increased after 6-18 months treatment, from 2.0 ± 1.1 to 6.8 ± 3.2 mL and 2.1 ± 1.1 to 8.8 ± 3.9 mL, respectively. Only six patients of group 3 had their testicular volumes increased but no statistically significant. Among the patients with testes growth, 34 patients of group 1 and 48 patients of group 2 achieved spermatogenesis, and three of them made their wives pregnant naturally. During the follow-up after treatment, there were 36 patients finally defined as delayed puberty, and 204 patients defined as idiopathic hypogonadotropic hypogonadism.

CONCLUSIONS:

For the hormonal treatment of HH, testosterone therapy could not stimulate testes growth and spermatogenesis, but HCG therapy and hCG/hMG combination therapy both are effective, while hCG/hMG combination therapy could achieve better therapeutic effects.

• Authors: Luo Yang, Si Xiao Zhang, Qiang Dong, Zi Bing Xiong, Xiang Li
• Journal: International urology and nephrology (Int Urol Nephrol) Vol. 44 Issue 2 Pg. 393-9 (Apr 2012) ISSN: 1573-2584 [Electronic] Netherlands
• PMID: 21989858 (Publication Type: Clinical Trial, Comparative Study, Journal Article)

Chemical References

• Androgens
• Chorionic Gonadotropin
• Reproductive Control Agents
• Testosterone
• Luteinizing Hormone
• Follicle Stimulating Hormone

Topics

• Administration, Oral
• Adolescent
• Adult
• Androgens (administration & dosage, therapeutic use)
• Chorionic Gonadotropin (administration & dosage, therapeutic use)
• Dose-Response Relationship, Drug
• Drug Therapy, Combination
• Follicle Stimulating Hormone (blood)
• Follow-Up Studies
• Hormone Replacement Therapy (methods)
• Humans
• Hypogonadism (complications, drug therapy, metabolism)
• Infertility, Male (drug therapy, etiology)
• Injections, Intramuscular
• Kallmann Syndrome (complications, drug therapy, metabolism)
• Luteinizing Hormone (blood)
• Male
• Middle Aged
• Organ Size (drug effects)
• Reproductive Control Agents (administration & dosage, therapeutic use)
• Retrospective Studies
• Spermatogenesis (drug effects)
• Testis (drug effects, pathology)
• Testosterone (administration & dosage, pharmacokinetics, therapeutic use)
• Time Factors
• Treatment Outcome
• Young Adult