Objective: The most used therapeutic guidelines for the induction of male puberty in hypogonadotropic hypogonadism (HH) are GnRH in subcutaneous pulsatile infusion and HCG in monotherapy or combined with FSH in intramuscular injection. The objective of this study was to evaluate the efficacy of subcutaneous HCG with or without FSH in induction of male puberty in patients with HH.
Patients and methods: Descriptive study of patients with HH treated with HCG subcutaneously (s.c.) with or without FSH, for induction of male puberty (20042015). The Treatment was initiated with HCG 500 UI/72h s.c., periodic monitoring of testosterone, testicular volume and semen analysis was realized, adjusting doses up to 2500 UI/72h. If no answer obtained after one year, combined treatment with FSH s.c. was started.
Analyzed data: Cause of HH, age, testosterone levels, testicular volume, semen, dose of HCG and FSH treatment. Pubertal development assessed by testosterone levels, testicular volume and normalization of spermatogenesis.
Results: Nine patients. 17.2±1.8 years old (1520). Cause of HH: four Idiopathics, four craniopharyngiomas and one adenohypophysis hypoplasia. Dose of HCG: 1666±821.6U/72 h. Two patients required combined treatment with FSH. Treatment period: 32.2±9.5 months. Testosterone levels were normalized in 100% of cases (7.34±5.1 ng/ml). 95% increased testicular volume: 13.5±4.4 ml (1020). The spermiogram was performed in 80% of cases at the end of treatment, with oligospermia in all cases. No presence of side effects.
Conclusions: Subcutaneous gonadotropin therapy is effective in induction of male puberty in HH. Treatment with subcuataneous HCG alone is successful. No presence of side effects.
20 - 23 May 2017
European Society of Endocrinology