Download PDF
Horm Metab Res 2014; 46(09): 668-673
DOI: 10.1055/s-0034-1375686
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Comparison of Therapeutic Response to Gonadotropin Therapy Between Chinese Male Adolescents and Young Adults with Hypogonadotropic Hypogonadism Caused by Pituitary Stalk Interruption

Q. Wang
1   Shandong Provincial Hospital affiliated to Shandong University, Jinan, China
,
W. Jiang
1   Shandong Provincial Hospital affiliated to Shandong University, Jinan, China
,
G. Li
1   Shandong Provincial Hospital affiliated to Shandong University, Jinan, China
,
L. Tang
1   Shandong Provincial Hospital affiliated to Shandong University, Jinan, China
,
Y. Hu
1   Shandong Provincial Hospital affiliated to Shandong University, Jinan, China
› Author Affiliations
Further Information

Publication History

received 26 November 2013

accepted after second 24 April 2014

Publication Date:
27 May 2014 (online)

Also available at
    Permissions and Reprints

Abstract

Hypogonadotropic hypogonadism (HH) is common in pituitary stalk interruption (PSI) patients. However, the optimal timing and effective regimen in the management of the pituitary-gonadal axis deficiency is still controversial. This study involved a retrospective review of 38 male patients with HH resulting from PSI. The HH patients were subdivided according to their ages into 2 experiment groups: Group I (adolescents, 14–18 years old, 25 cases) and Group II (young adults, 18–24 years old, 13 cases). To compare the therapeutic response to exogenous gonadotropin, a control analysis was carried out in the experimental groups with age-matched control groups. Before gonadotropin therapy, no significant increases in gonadal hormones were noted in either of the 2 experimental groups. After treatment with human chorionic gonadotropin (hCG) for less than 6 months, the hormone levels of pituitary-gonadal axis significantly increased in group I than in group II. After adding the human menopause gonadotropin (hMG) for 6 months, the gonadal hormone levels of group II were significantly increased. In addition, the Tanner stage and penis lengths in group I were significantly improved. There was no significant adverse impact on BMI and height velocity (HV) after less than one year therapy. A prolonged hypogonadotropic period without treatment may be responsible for testicular dysfunction in HH males caused by PSI. Early supplementary therapy with hCG and hMG is beneficial for the recovery of gonadal hormone and development of secondary sexual characteristics.

Key words

gonadotropin - hypogonadism - hypopituitarism - pituitary
 

  • References

  • 1 Vicari E, Mongioì A, Calogero AE, Moncada ML, Sidoti G, Polosa P, D’Agata R. Therapy with human chorionic gonadotrophin alone induces spermatogenesis in men with isolated hypogonadotrophic hypogonadism – long-term follow-up. Int J Androl 1992; 15: 320-329
    CrossrefPubMedGoogle Scholar
  • 2 Zacharin M, Sabin MA, Nair VV, Dabadghao P. 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. Fertil Steril 2012; 98: 836-842
    CrossrefPubMedGoogle Scholar
  • 3 Warne DW, Decosterd G, Okada H, Yano Y, Koide N, Howles CM. A combined analysis of data to identify predictive factors for spermatogenesis in men with hypogonadotropic hypogonadism treated with recombinant human follicle-stimulating hormone and human chorionic gonadotropin. Fertil Steril 2009; 92: 594-604
    CrossrefPubMedGoogle Scholar
  • 4 Kazlauskaite R, Evans AT, Villabona CV, Abdu TA, Ambrosi B, Atkinson AB, Choi CH, Clayton RN, Courtney CH, Gonc EN, Maghnie M, Rose SR, Soule SG, Tordjman K. Consortium for evaluation of corticotropin test in hypothalamic-pituitary adrenal insufficiency: a meta-analysis. J Clin Endocrinol Metab 2008; 93: 4245-4253
    CrossrefPubMedGoogle Scholar
  • 5 Di Iorgi N, Napoli F, Allegri AE, Olivieri I, Bertelli E, Gallizia A, Rossi A, Maghnie M. Diabetes insipidus – diagnosis and management. Horm Res Paediatr 2012; 77: 69-84
    CrossrefPubMedGoogle Scholar
  • 6 Segal TY, Mehta A, Anazodo A, Hindmarsh PC, Dattani MT. Role of gonadotropin-releasing hormone and human chorionic gonadotropin stimulation tests in differentiating patients with hypogonadotropic hypogonadism from those with constitutional delay of growth and puberty. J Clin Endocrinol Metab 2009; 94: 780-785
    CrossrefPubMedGoogle Scholar
  • 7 Harrington J, Palmert MR. Clinical review: Distinguishing constitutional delay of growth and puberty from isolated hypogonadotropic hypogonadism: critical appraisal of available diagnostic tests. J Clin Endocrinol Metab 2012; 97: 3056-3067
    CrossrefPubMedGoogle Scholar
  • 8 Sakamoto H, Yajima T, Nagata M, Okumura T, Suzuki K, Ogawa Y. Relationship between testicular size by ultrasonography and testicular function: measurement of testicular length, width, and depth in patients with infertility. Int J Urol 2008; 15: 529-533
    CrossrefPubMedGoogle Scholar
  • 9 Hampl R, Kubatova J, Heracek J, Sobotka V, Starka L. Hormones and endocrine disruptors in human seminal plasma. Endocr Regul 2013; 47: 149-158
    CrossrefPubMedGoogle Scholar
  • 10 Mastrogiacomo I, Motta RG, Botteon S, Bonanni G, Schiesaro M. Achievement of spermatogenesis and genital tract maturation in hypogonadotropic hypogonadic subjects during long term treatment with gonadotropins or LHRH. Andrologia 1991; 23: 285-289
    PubMedGoogle Scholar
  • 11 Kung AW, Zhong YY, Lam KS, Wang C. Induction of spermatogenesis with gonadotrophins in Chinese men with hypogonadotrophic hypogonadism. Int J Androl 1994; 17: 241-247
    CrossrefPubMedGoogle Scholar
  • 12 Jones TH, Darne JF. Self-administered subcutaneous human menopausal gonadotrophin for the stimulation of testicular growth and the initiation of spermatogenesis in hypogonadotrophic hypogonadism. Clin Endocrinol (Oxf) 1993; 38: 203-208
    CrossrefPubMedGoogle Scholar
  • 13 Liu PY, Gebski VJ, Turner L, Conway AJ, Wishart SM, Handelsman DJ. Predicting pregnancy and spermatogenesis by survival analysis during gonadotrophin treatment of gonadotrophin-deficient infertile men. Hum Reprod 2002; 17: 625-633
    CrossrefPubMedGoogle Scholar
  • 14 Liu PY, Baker HW, Jayadev V, Zacharin M, Conway AJ, Handelsman DJ. Induction of spermatogenesis and fertility during gonadotropin treatment of gonadotropin-deficient infertile men: predictors of fertility outcome. J Clin Endocrinol Metab 2009; 94: 801-808
    CrossrefPubMedGoogle Scholar
  • 15 King TF, Hayes FJ. Long-term outcome of idiopathic hypogonadotropic hypogonadism. Curr Opin Endocrinol Diabetes Obes 2012; 19: 204-210
    CrossrefPubMedGoogle Scholar
  • 16 Farhat R, Al-zidjali F, Alzahrani AS. Outcome of gonadotropin therapy for male infertility due to hypogonadotrophic hypogonadism. Pituitary 2010; 13: 105-110
    CrossrefPubMedGoogle Scholar
  • 17 Tachiki H, Ito N, Maruta H, Kumamoto Y, Tsukamoto T. Testicular findings, endocrine features and therapeutic responses of men with acquired hypogonadotropic hypogonadism. Int J Urol 1998; 5: 80-85
    CrossrefPubMedGoogle Scholar
  • 18 Salenave S, Trabado S, Maione L, Brailly-Tabard S, Young J. Male acquired hypogonadotropic hypogonadism: diagnosis and treatment. Ann Endocrinol (Paris) 2012; 73: 141-146
    CrossrefPubMedGoogle Scholar
  • 19 Koeva Y, Bakalska M, Atanassova N, Georgieva K, Davidoff M. Age-related changes in the expression of 11beta-hydroxysteroid dehydrogenase type 2 in rat Leydig cells. Folia Histochem Cytobiol 2009; 47: 281-287
    PubMedGoogle Scholar
  • 20 Young J, Couzinet B, Nahoul K, Brailly S, Chanson P, Baulieu EE, Schaison G. Panhypopituitarism as a model to study the metabolism of dehydroepiandrosterone (DHEA) in humans. J Clin Endocrinol Metab 1997; 82: 2578-2585
    CrossrefPubMedGoogle Scholar
  • 21 Moudgal NR, Sairam MR. Is there a true requirement for follicle stimulating hormone in promoting spermatogenesis and fertility in primates?. Hum Reprod 1998; 13: 916-919
    CrossrefPubMedGoogle Scholar
  • 22 Plant TM, Marshall GR. The functional significance of FSH in spermatogenesis and the control of its secretion in male primates. Endocr Rev 2001; 22: 764-786
    CrossrefPubMedGoogle Scholar
  • 23 Pareek TK, Joshi AR, Sanyal A, Dighe RR. Insights into male germ cell apoptosis due to depletion of gonadotropins caused by GnRH antagonists. Apoptosis 2007; 12: 1085-1100
    CrossrefPubMedGoogle Scholar