Combined hMG/hCG treatment in subfertile men with idiopathic normogonadotrophic oligozoospermia

Abstract

Forty-eight patients with idiopathic normogonadotrophic oligozoospermia were treated with hMG plus hCG over a period of 3 months. Total sperm output increased by an average of 15.3 million spermatozoa per ejaculate and a similar significant increase was seen in the percentage of motile spermatozoa. Sixteen of the 48 men increased their sperm output by 25 million or more. Follow-up information was available in 33 patients. Ten pregnancies were reported within one year after initiation of treatment. Six of 12 responders impregnated their wives, whereas only 4 pregnancies were reported in a group of 21 non-responders. Endocrinological investigations showed no differences in mean basal levels of LH and FSH, or in the gonadotrophin response to a 100 micrograms GnRH stimulation between responders and non-responders. However, mean basal plasma testosterone concentration was significantly lower in the responder group than in the non-responders. Responsiveness to gonadotrophin treatment tended to be better in patients with basal plasma testosterone concentration lower than 4.5 ng/ml. Combined hMG/hCG treatment in subfertile men with idiopathic oligozoospermia seems to be efficient in only a small proportion of cases.

Reduction of Testicular Human Chorionic Gonadotropin Receptors by Human Chorionic Gonadotropin in vivo and in vitro

“…These findings are consistent with those of Davies et al [13], in which the LH receptor binding capacity of adult rhesus monkeys was significantly reduced for 4 days by the administration of 10,000 IU hCG. There fore, it is at least clear that massive (5,000 IU) adminis tration of hCG causes reduction in testicular hCG recep tors in adult men, probably followed by desensitization of the Leydig cell function [14], Although it is unclear how the reduction in the hCG receptors can contribute to the desensitization of Leydig cells, the present find ings are clinically important, because hCG is frequently used in the treatment of such diseases as idiopathic male infertility [15] and hypogonadotropic hypogonadism [ 16], in which the appropriate dosage of hCG has not yet been established.…”

Treatment of idiopathic oligozoospermia with combined human chorionic gonadotropin/human menopausal gonadotrophin: A randomised, double‐blinded, placebo‐controlled clinical study

“…In the study of Knuth et al, thirty‐nine severe oligospermi a men have been recruited from a placebo‐controlled, double‐blinded trial, where sperm concentrations, total number of motile spermatozoa and the percentage of spermatozoa with normal morphology were similar in hCG/hMG‐treated group and placebo‐controlled group. However, Schill et al, demonstrated that combined hCH/hMG therapy in 48 subfertile male with idiopathic oligozoospermia was effective in a part of cases. Based on the above evidence, we designed this larger‐sampled, randomised, placebo‐controlled, double‐blinded clinical study to evaluate the success of hCG/hMG therapy in male with idiopathic oligozoospermia in Chinese population and explore.…”

“…However, there were relatively few studies concerning the effects of hCG/hMG on the male with normogonadotrophic oligozoospermia. Schill, Jüngst, Unterburger, & Braun, reported that combined hMG/hCG therapy in sterile male with idiopathic oligozoospermia was efficient in a part of cases. However, controversy still exists concerning whether gonadotrophin therapy is beneficial in normogonadotrophic oligozoospermic patients (Knuth, Hönigl, Bals‐Pratsch, Schleicher, & Nieschlag, ; Lunenfeld, Olchovsky, Tadir, & Glezerman, ).…”

Reduction of Human and Rat Testicular Follicle Stimulating Hormone Receptors by Human Menopausal Gonadotrophin in Vivo and in Vitro

“…However, the fact that only a single injection of 150 IU of hMG resulted in 50% reduction of FSH binding sites in the human testes for at least 5 d is important. This is because hMG combined with hCG has been used often in many patients (Schill et al, 1982;Finkel et a/., 1985). For the use of hCG, however, the administration of small doses at short time intervals has recently been recommended, in order to avoid the down-regulation of LH (hCG) receptors in the Leydig cells (Calvo et al, 1984; Smals et al, 1984).…”