Subcutaneous gonadotropin therapy in male patients with hypogonadotropic hypogonadism

Abstract

Objective: The response to subcutaneous (SC) gonadotropin replacement therapy, using human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) or hCG alone, was evaluated in male hypothalamic hypogonadism.

Design: Sixteen patients with hypothalamic hypogonadism were treated with gonadotropins for induction of puberty and normalization of spermatogenesis. The results were analyzed retrospectively.

Setting: The study was carried out in a clinical endocrinology department providing tertiary care and in private practices of endocrinology.

Patients: Eight patients with idiopathic hypogonadotropic hypogonadism and eight patients with Kallmann's syndrome in prepubertal or early pubertal stages.

Interventions: Human chorionic gonadotropin and hMG were administered SC in individual dosages.

Main outcome measures: Increase of serum testosterone (T), testicular volume, semen volume, and sperm count were evaluated.

Results: Normalization of serum T and complete sexual maturation was achieved in all patients. Spermatogenesis was induced in all but two patients. Seven patients showed normal findings in semen volume and sperm count, and two patients had semen quality close to normal. In five patients sperm count remained less than 10 x 10(6)/mL.

Conclusions: The results obtained by SC gonadotropin replacement prove this mode of administration to be effective in stimulating steroidogenesis and spermatogenesis in hypogonadotropic males.