Causes of hypogonadotropic hypogonadism predict response to gonadotropin substitution in adults

Andrology
J RohayemM Zitzmann

Abstract

Germ cell and Sertoli cell proliferation and maturation in human testes occur in three main waves, during the late fetal and early neonatal period and at early puberty. They are triggered by periods of increased activity of the hypothalamic-pituitary-gonadal (HPG) axis. In hypogonadotropic hypogonadism (HH), these processes are variably disturbed. The objective of this study was to explore whether success of gonadotropin replacement in HH men is predictable by the origin of HH, indicating time of onset and severity of GnRH/gonadotropin deficiency. The data of 51 adult HH patients who had undergone one cycle of hCG/FSH treatment were reviewed. Five groups were established, according to the underlying HH origin. Therapeutic success by final bi-testicular volumes (BTVs) final sperm concentrations (SC) and conception rates were compared and related to baseline parameters, indicative of the degree of HPG-axis disruption. Overall, BTVs rose from 13 ± 15 to 27 ± 15 mL, spermatogenesis was induced in 98%, with mean SCs of 15 ± 30 mill/mL, spontaneous pregnancies in 37% and additional 18% via intracytoplasmic sperm injection. Kallmann syndrome patients had the poorest responses (BTV: 16.9 ± 10 mL; SC: 3.5 ± 5.6 mill/mL), followed by pat...Continue Reading

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Citations

Aug 24, 2016·Expert Opinion on Emerging Drugs·Aydogan Aydogdu, Ronald S Swerdloff
Jan 31, 2019·Endocrine Reviews·Jacques YoungNelly Pitteloud
Mar 9, 2018·Endocrine Connections·Mikkel AndreassenNiels Jørgensen
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May 20, 2020·Journal of Clinical Medicine·Maurizio De Rocco PonceAndrea Garolla
Jan 23, 2019·The Journal of Clinical Endocrinology and Metabolism·Alexander Siegfried BuschSabine Kliesch
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Jan 13, 2021·Journal of Assisted Reproduction and Genetics·Guy C MorrisDavid J Cahill

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