Endocrine Abstracts

JOINT2877

Purpose: Hypogonadotropic hypogonadism refers to patients with damage to the hypothalamus or pituitary gland, resulting in low levels of FSH, LH, and testosterone, as well as prepubertal levels observed on the GnRH stimulation test. This study aimed to compare the efficacy of gonadotropin therapy and testosterone replacement therapy (TRT) in young males with hypogonadotropic hypogonadism (HH).

Methods: A retrospective analysis was conducted on 70 male HH patients under 18 years old, treated between November 2005 and December 2023. Patients were diagnosed based on clinical symptoms, underlying diseases, genetic confirmation, or prepubertal hormone levels on GnRH stimulation test. Clinical parameters and laboratory data were assessed every 6 months for up to 3 years.

Results: The etiology was congenital in 25.7% (mainly Kallmann syndrome) and acquired in 74.3% (primarily brain tumors). Of the 70 patients, 56 received gonadotropin therapy and 14 received TRT. No statistically significant differences were found between the two treatment groups in testosterone levels, growth parameters, or laboratory data. Both treatments significantly increased testicular volume and stretched penile length, but the difference between treatments was not statistically significant. Sperm analysis revealed that sperm was detected in 17 individuals (70.8%) in the gonadotropin treatment group and in 2 individuals (66.6%) in the testosterone treatment group.

Conclusions: Both gonadotropin and testosterone replacement therapies were effective in inducing puberty in adolescent males with HH. The study suggests that treatment choice should be individualized based on patient characteristics and regularly monitored for efficacy.