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Testicular Findings, Endocrine Features and Therapeutic Responses of Men with Acquired Hypogonadotropic Hypogonadism
Author(s) -
Tachiki Hitoshi,
Ito Naoki,
Maruta Hiroshi,
Kumamoto Yoshiaki,
Tsukamoto Taiji
Publication year - 1998
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.1998.tb00244.x
Subject(s) - medicine , hypogonadotropic hypogonadism , endocrine system , gynecology , endocrinology , physiology , pediatrics , hormone
Background Men with acquired hypogonadotropic hypogonadism (AHH) who desire restoration of fertility are treated with exogenous gonadotropin. However, gonadotropin (Gn) therapy does not always restore testicular function. It is unknown whether the therapeutic responses to Gn therapy correlate with their testicular histological findings. Thus, we analyzed factors influencing testicular dysfunction and therapeutic responses in AHH. Methods Of 21 men with AHH, 11 had no postmeiotic germ cells and were classified as the severe spermatogenic failure group. These were compared with the other 10 patients who had postmeiotic germ cells and comprised the mild spermatogenic failure group. Results: Testicular volume and tubular diameter were significantly smaller, and the basement membrane and tunica propria were significantly thicker in the severe failure group. The gonadotropin basal level and response to exogenous gonadotropin‐releasing hormone, and the testosterone response to exogenous human chorionic gonadotropin were significantly lower in the severe failure group of patients. Also, the recovery of spermatogenesis and testosterone secretory potentials was poor in the cases with a duration between diagnosis and treatment of 2 years or more. Conclusion Longer periods without treatment may be responsible for irreversible testicular dysfunction in AHH. Gn therapy should be initiated very soon after the diagnosis of AHH if fertility is desired.