Efficacy of follitropin-alpha versus human menopausal gonadotropin for male patients with congenital hypogonadotropic hypogonadism

Ortaç, Mazhar; Hidir, Muhammed; Çilesiz, Nusret Can; Kadıoğlu, Ateş

doi:10.5152/tud.2019.19177

Cited by 6 publications

(6 citation statements)

References 18 publications

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“… 38 , 66 , 67 Seven other studies described that patients with cryptorchidism had lower or delayed attainment of spermatogenesis but did not report statistical significance. 16 , 35 , 36 , 46 , 62 , 68 , 69 In general, studies did not describe whether gonadotropins induced testicular descent (this occurred in one case in one study 70 )—the majority of patients had previously resolved cryptorchidism treated with orchidopexy in childhood.…”

Section: Resultsmentioning

confidence: 99%

Gonadotropins for pubertal induction in males with hypogonadotropic hypogonadism: systematic review and meta-analysis

Alexander,

Faruqi,

Farquhar

et al. 2023

European Journal of Endocrinology

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Objective Hypogonadotropic hypogonadism is characterised by inadequate secretion of pituitary gonadotropins, leading to absent, partial or arrested puberty. In males, classical treatment with testosterone promotes virilisation but not testicular growth or spermatogenesis. To quantify treatment practices and efficacy, we systematically reviewed all studies investigating gonadotropins for achievement of pubertal outcomes in males with hypogonadotropic hypogonadism. Design Systematic review and meta-analysis Methods A systematic review of Medline, EMBASE, Global Health, and PsychInfo databases in December 2022. Risk of Bias 2.0/Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I)/National Heart, Lung, and Blood Institute (NHLBI) tools for quality appraisal. Protocol registered on PROSPERO (CRD42022381713). Results After screening 3,925 abstracts, 103 studies were identified including 5,328 patients from 21 countries. Average age of participants was <25 years in 45.6% (n=47) of studies. Studies utilised human chorionic gonadotropin (hCG) (n=93, 90.3% of studies), human menopausal gonadotropin (hMG) (n=42, 40.8%), follicle-stimulating hormone (FSH) (n=37, 35.9%), and gonadotropin-releasing hormone (GnRH) (28.2% n=29). Median reported duration of treatment/follow-up was 18 months (interquartile range (IQR) 10.5-24 months). Gonadotropins induced significant increases in testicular volume, penile size and testosterone in over 98% of analyses. Spermatogenesis rates were higher with hCG + FSH (86%, 95% Confidence Interval (CI) 82-91%) as compared to hCG alone (40%, 95% CI 25-56%). However, study heterogeneity and treatment variability were high. Conclusions This systematic review provides convincing evidence of efficacy of gonadotropins for pubertal induction. However, there remains substantial heterogeneity in treatment choice, dose, duration, and outcomes assessed. Formal guidelines and randomised studies are needed.

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Section: Resultsmentioning

confidence: 99%

Gonadotropins for pubertal induction in males with hypogonadotropic hypogonadism: systematic review and meta-analysis

Alexander,

Faruqi,

Farquhar

et al. 2023

European Journal of Endocrinology

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“…HMG includes LH and FSH pathways and has been on the market since the 1960s. In the meantime, a recombinant type of human FSH (rFSH) has been developed, showing pure FSH activity in contrast with HMG [36]. Even though it has some LH activity, HMG is not able to preserve the Leydig cell function and sufficient spermatogenesis.…”

Section: Alternatives To Trt To Raise Testosterone While Maintaining ...mentioning

confidence: 99%

“…Even though it has some LH activity, HMG is not able to preserve the Leydig cell function and sufficient spermatogenesis. Therefore, it is often used in combination with HCG to trigger spermatogenesis in patients with hypogonadotropic hypogonadism [36].…”

Section: Alternatives To Trt To Raise Testosterone While Maintaining ...mentioning

confidence: 99%

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Management of Male Fertility in Hypogonadal Patients on Testosterone Replacement Therapy

Fink,

Ide,

Horie

2024

Medicina

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Testosterone is crucial in regulating several body functions in men, including metabolic, sexual, and cardiovascular functions, bone and muscle mass, and mental health. Therefore, optimizing testosterone levels in men is an important step to maintaining a healthy body and mind, especially as we age. However, traditional testosterone replacement therapy has been shown to lead to male infertility, caused by negative feedback in the hypothalamic–pituitary–gonadal (HPG) axis. Recent advances in research have led to the discovery of many new methods of administration, which can have more or less suppressive effects on the HPG axis. Also, the usage of ancillary medications instead of or after testosterone administration might help maintain fertility in hypogonadal patients. The goal of this narrative review is to summarize the newest methods for optimizing fertility parameters in patients undergoing treatment for hypogonadism and to provide the necessary information for healthcare providers to make the right treatment choices.

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“…On the other hand, individuals with milder (partial) CHH tend to experience more favourable spermatogenesis induction outcomes that are comparable to those with acquired hypogonadotropic hypogonadism. In a retrospective study by Ortac and colleagues, conventional gonadotropin therapy (addition of FSH to hCG when azoospermia persists for ≥6 months) in their cohort of 112 men with a mean baseline testicular volume of ≥4 mL (5–5.3 mL) achieved a spermatogenic rate of 85% 68 . Therefore, such individuals could potentially be treated with a less-intense approach of hCG monotherapy before adjunctive FSH is considered, although combined treatment from the outset would also be valid.…”

Section: Replicating Minipuberty Through Gonadotropin Treatment: the Key To Optimising Outcomesmentioning

confidence: 99%

Recent advances in understanding and managing Kallmann syndrome

Swee¹,

Quinton²,

Maggi³

2021

Fac Rev

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Many of the recent advances in our understanding of human reproductive biology and its genetic basis have arisen directly via the genetic investigation of patients with Kallmann syndrome and their families. The disease is characterised by the association of an isolated defect in the secretion (or, less commonly, action) of gonadotropin-releasing hormone (GnRH) and consequent infertility, with anosmia and potentially other associated non-reproductive features. GnRH-producing neurons are located in the hypothalamic brain region after a peculiar migration during embryonic life. To date, different genes affecting GnRH neuron development/migration have so far been implicated in Kallmann syndrome, but our knowledge of the genetic basis of the syndrome remains incomplete. From a clinical point of view, the disease has suffered from a lack of definitive diagnosis and treatment, and although progress has been made in terms of timely diagnosis and evidence-based treatment of patients, implementation remains inconsistent. These aspects will be discussed in this review, which examines new strategies for arriving at more evidence-based and patient-centred medical practice in Kallmann syndrome.

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Efficacy of follitropin-alpha versus human menopausal gonadotropin for male patients with congenital hypogonadotropic hypogonadism

Abstract: I n d e x e d i n P u b M e d , W e b o f S c i e n c e a n d S c o p u s Pankaj M. Joshi and Sanjay B. Kulkarni. A new technique of double-face buccal graft urethroplasty for female urethral strictures.

Cited by 6 publications

References 18 publications

Gonadotropins for pubertal induction in males with hypogonadotropic hypogonadism: systematic review and meta-analysis

Gonadotropins for pubertal induction in males with hypogonadotropic hypogonadism: systematic review and meta-analysis

Management of Male Fertility in Hypogonadal Patients on Testosterone Replacement Therapy

Recent advances in understanding and managing Kallmann syndrome

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