[Stimulation of spermatogenesis in men with hypogonadotropic hypogonadism]

Hypogonadotropic hypogonadism (HH) is characterizes by infertility. In patients with congenital HH (CHH) is caused by the deficient production, secretion or action of gonadotropin-releasing hormone (GnRH), and clinically is characterized by an absence of puberty and infertility. In patients with acquired HH (AHH) impaired fertility is the main symptom. An important diagnostic challenge is to distinguish CHH from constitutional delay of growth and puberty (CDGP). In patients with CHH after stimulation of puberty and in patients with AHH after diagnosis, hormonal stimulation of spermatogenesis is necessary. For most men with low sperm concentrations due to HH, GnRH or gonadotropin therapy effectively increases spermatogenesis. Such treatment may help the patient obtain offspring using the natural method or with the use of assisted reproduction techniques (ART). Gonadotropin therapy is not recommended for men with idiopathic infertility and normal LH, and FSH levels.