Addition of recombinant follicle-stimulating hormone to human chorionic gonadotropin treatment in adolescents and young adults with hypogonadotropic hypogonadism promotes normal testicular growth and may promote early spermatogenesis

摘要

Objective: To assess the effect on spermatogenesis of adding recombinant follicle-stimulating hormone (FSH) to human chorionic gonadotropin (hCG) treatment protocols for adolescent/young adult males with hypogonadotropic hypogonadism (HH). Design: Observational descriptive study. Setting: Outpatient clinics. Patient(s): Nineteen males with hypogonadotropic hypogonadism, aged 14.5 to 31.0 years. Intervention(s): Treatment with either hCG treatment alone (n = 9; group 1) or in combination with recombinant FSH (n = 10; group 2), over 6 to 9 months. Main Outcome Measure(s): Combined testicular volume (CTV) and testosterone, inhibin B, semen/urine analysis at 6 to 9 months. Result(s): There were no differences between the two groups in baseline variables or changes in CTV with treatment. Despite this, evidence of spermatogenesis was present in all group 2 patients by 9 months (range 0.2 to 15 × 10 6/mL) compared with three of nine patients in group 1 (range 0 to 1 × 10 6/mL). Whole group and subgroup analyses did not demonstrate any statistically significant correlations between age at onset of treatment and either CTV or sperm count. Conclusion(s): The addition of recombinant FSH to hCG treatment protocols in adolescent/young adult HH males results in normal testicular growth and may hasten induction of spermatogenesis.