Document Detail


Outcome of gonadotropin therapy for male infertility due to hypogonadotrophic hypogonadism.
MedLine Citation:
PMID:  19838805     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Data on the management of male infertility secondary to hypogonadotrophic hypogonadism (HH) are limited. We report our extensive experience with intramuscular injections of gonadotropins, one of the two methods used for this purpose. Eighty-seven married men (median age, 28 years) with either congenital (47 men) or acquired (40 men) HH were treated for a median of 26 months (range, 6-57) with intramuscular injections of gonadotropins (HCG/HMG) three times weekly for the purpose of achieving fertility. The outcome was assessed by achievement of one or more pregnancies. Of the 151 courses of HCG/HMG treatment administered to 87 patients, 85 courses (56.3%) were successful, resulting in 85 pregnancies (median pregnancy rate 2, range 1-10) in 35 patients (40%) while 52 cases did not achieve pregnancy. Responders had larger pretherapy testicular volume (9 +/- 3.6 cc) compared to non-responders [(5.7 +/- 2.0 cc), P < 0.0001], but there was no difference in age, LH, FSH or testosterone levels or doses of HCG/HMG used. The pregnancy rate was similar in those with congenital (51.4%) and acquired causes (48.6%) of HH (P = 0.83). Only testicular size was predictive of conception (P < 0.001, odds ratio 1.5, 95% CI 1.21-1.92) while age, pretherapy levels of testosterone, LH, FSH and doses of HCG/HMG did not predict the success of pregnancy. Gonadotropins are moderately effective in achieving one to several pregnancies in HH. Only testicular size is predictive of success in achieving pregnancy. There is no difference in success between those with congenital and acquired causes of HH.
Authors:
Rafif Farhat; Fatma Al-zidjali; Ali S Alzahrani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pituitary     Volume:  13     ISSN:  1573-7403     ISO Abbreviation:  Pituitary     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-04-19     Completed Date:  2010-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9814578     Medline TA:  Pituitary     Country:  United States    
Other Details:
Languages:  eng     Pagination:  105-10     Citation Subset:  IM    
Affiliation:
Department of Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Chorionic Gonadotropin / metabolism
Follicle Stimulating Hormone / metabolism
Gonadotropins / therapeutic use*
Humans
Hypogonadism / complications*,  metabolism
Infertility, Male / drug therapy*,  etiology*,  metabolism
Luteinizing Hormone / metabolism
Male
Menotropins / metabolism
Retrospective Studies
Testosterone / metabolism
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 0/Gonadotropins; 58-22-0/Testosterone; 61489-71-2/Menotropins; 9002-67-9/Luteinizing Hormone; 9002-68-0/Follicle Stimulating Hormone

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