Premium
Fertility induction in hypogonadotropic hypogonadal men
Author(s) -
Prior Matthew,
Stewart Jane,
McEleny Kevin,
Dwyer Andrew A.,
Quinton Richard
Publication year - 2018
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13850
Subject(s) - hypogonadotropic hypogonadism , spermatogenesis , endocrinology , medicine , fertility , infertility , male infertility , endocrine system , sperm , follicle stimulating hormone , hormone , biology , luteinizing hormone , andrology , population , pregnancy , environmental health , genetics
Summary Men with hypogonadotropic hypogonadism ( HH ) are typically azoospermic, and yet HH is one of the few treatable forms of male infertility. Sperm induction protocols using gonadotrophins aim to replicate the natural endocrine control of spermatogenesis. Previously virilised men with adult‐onset HH and normal testicular volume respond well to monotherapy in which human chorionic gonadotrophin ( hCG ) acts as a long‐acting LH ‐analogue stimulating spermatogenesis. However, this approach is rarely successful for men with congenital HH ( CHH ) (eg, Kallmann syndrome), for whom combined gonadotrophin therapy ( hCG + follicle‐stimulating hormone [ FSH ]) is an absolute requirement to maximise fertility potential. Key baseline predictors of successful spermatogenesis‐induction include prior spontaneous testicular development (ie , testicular volume [ TV ] > 4 mL), serum inhibin B ( I B ) concentration >60 pg/mL and no history of maldescended testes (cryptorchidism).