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Cotreatment with growth hormone for induction of spermatogenesis in patients with hypogonadotropic hypogonadism
Z Shoham1, G S Conway, H Ostergaard
1Cobbold Laboratories, Medical Unit University College and Middlesex School of Medicine, Middlesex Hospital, London, United Kingdom.
Objective:
To induce spermatogenesis by cotreatment with growth hormone (GH) and gonadotropin therapy in patients with hypogonadotropic hypogonadism who had failed to respond adequately to conventional treatment.
Design:
Cotreatment with GH (4 IU) and human menopausal gonadotropin, 150 IU of follicle-stimulating hormone and 150 IU of luteinizing hormone (LH), three times a week, and human chorionic gonadotropin, 2,500 IU, two times a week for 24 weeks after unsuccessful treatment for 12 weeks with either pulsatile LH-releasing hormone or gonadotropins.
Setting:
Specialist Reproductive Endocrine Unit.
Patients, Participants:
Seven patients, four of whom had failed to respond adequately to the conventional treatment.
Main Outcome Measures:
Serum testosterone (T), estradiol, and sperm production, testicular and semen volume, and serum insulin-like growth factor-I and inhibin concentrations.
Results:
Of the four patients who received cotreatment with GH, three increased T secretion (greater than 11 nmol/L) within a relatively short period of time, two produced adequate amount of sperm (13 and 12 x 10(6)/mL), and one of them impregnated his wife. One patient did not respond.
Conclusion:
The results offer a new approach to the problem of induction of spermatogenesis in patients who respond poorly to conventional treatment because cotreatment with GH enhanced T secretion and sperm production in a relatively short period of time.