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RESEARCH PRODUCT

Gonadotropic Therapy in Men with Hypogonadotropic Hypogonadism

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Many therapeutic regimens, differing in dose and duration, have been employed in the treatment of hypogonadotropic hypogonadism. This study presents the results from a regimen of hCG plus hMG plus testosterone combined treatment in 15 patients affected by selective hypogonadotropic hypogonadism. The patients were homogeneous in age (16–23 years), testicular size, aspermia, absence of prior hormonal treatment, and normal karyotype. They were administered 5000 IU of hCG plus 75 IU of hMG twice a week for two months and a single dose of depo-testosterone (250 mg) in the third month. This therapeutic plan was carried out continuously for eight three-month cycles (24 months). Sexual maturation and seminal parameters were checked every six months. All the patients improved in testicular size (from 4.6 ± 1.55 ml to 13 ± 3.5 ml) and secondary sexual characteristics (penis, scrotum, pubic hair), but facial and axillary hair in most patients remained abnormal. After 24 months, all of them had ejaculations, but only two were normo-spermic, and seven were still azoospermic. In patients with hypogonadotropic hypogonadism treated with gonadotropins there were better results in achieving sexual maturation than in improving seminal parameters. We believe that this differential response is due to multiple factors rather than a single factor.