Pulsatile GnRH Therapy May Restore Hypothalamus–Pituitary–Testis Axis Function in Patients With Congenital Combined Pituitary Hormone Deficiency: A Prospective, Self-Controlled Trial

Zheng, Junjie; Mao, Jiangfeng; Xu, Hongli; Wang, Xi; Huang, Bingkun; Liu, Zhaoxiang; Cui, Mingxuan; Xiong, Shuyu; Ma, Wanlu; Min, Le; Kaiser, Ursula B.; Nie, Min; Wu, Xueyan

doi:10.1210/jc.2016-3990

Cited by 18 publications

(15 citation statements)

References 34 publications

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“…Perinatal adverse events, including dystocia (83.1%, 49/59), abnormal foetal position (71.2%, 42/59) and history of hypoxia (28.8%, 17/59), were found to be more frequent in the PSIS patients in the current study (Table 1), which is consistent with results of another study performed by Zheng et al 29 wherein the prevalence of perinatal complications was 100%. Another study performed on Chinese PSIS patients showed that breech delivery occurred in 88.9% patients and a history of dystocia was noted for 34.5% patients 30 .…”

Section: Discussionsupporting

confidence: 92%

Identification of novel candidate pathogenic genes in pituitary stalk interruption syndrome by whole‐exome sequencing

Fang

Zhang

Cai

et al. 2020

J Cellular Molecular Medi

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Section: Discussionsupporting

confidence: 92%

Identification of novel candidate pathogenic genes in pituitary stalk interruption syndrome by whole‐exome sequencing

Fang

Zhang

Cai

et al. 2020

J Cellular Molecular Medi

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“…Testosterone levels increase in some, but not in all, cases, indicating the need of a treatment lasting more than 3 months in specific cases [68,69]. A useful predictor index for the response to treatment was suggested from this later study, since all patients with LH levels > 3.0 IU/L after 1 month of treatment were responders [68].…”

Section: Central Hypogonadism In Malesmentioning

confidence: 78%

Management of Hypopituitarism

Alexandraki

Grossman

2019

JCM

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Hypopituitarism includes all clinical conditions that result in partial or complete failure of the anterior and posterior lobe of the pituitary gland’s ability to secrete hormones. The aim of management is usually to replace the target-hormone of hypothalamo-pituitary-endocrine gland axis with the exceptions of secondary hypogonadism when fertility is required, and growth hormone deficiency (GHD), and to safely minimise both symptoms and clinical signs. Adrenocorticotropic hormone deficiency replacement is best performed with the immediate-release oral glucocorticoid hydrocortisone (HC) in 2–3 divided doses. However, novel once-daily modified-release HC targets a more physiological exposure of glucocorticoids. GHD is treated currently with daily subcutaneous GH, but current research is focusing on the development of once-weekly administration of recombinant GH. Hypogonadism is targeted with testosterone replacement in men and on estrogen replacement therapy in women; when fertility is wanted, replacement targets secondary or tertiary levels of hormonal settings. Thyroid-stimulating hormone replacement therapy follows the rules of primary thyroid gland failure with L-thyroxine replacement. Central diabetes insipidus is nowadays replaced by desmopressin. Certain clinical scenarios may have to be promptly managed to avoid short-term or long-term sequelae such as pregnancy in patients with hypopituitarism, pituitary apoplexy, adrenal crisis, and pituitary metastases.

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“…This represents the most physiological approach to replacing gonadotropin stimulation of the testis. Pulsatile GnRH administration can restore the development of adult secondary sex characteristics, normal testosterone serum levels, and spermatogenesis [117][118][119][120]. However, in spite of being the most physiological option, this treatment is not often used outside highly specialized centers, mainly in the United States, due to the prolonged use of an external pump that can be inconvenient and costly to maintained.…”

Section: Therapeutic Options To Improve Sperm Productionmentioning

confidence: 99%

Follicle-Stimulating Hormone (FSH) Action on Spermatogenesis: A Focus on Physiological and Therapeutic Roles

Santi

Crépieux

Reiter

et al. 2020

JCM

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Background: Human reproduction is regulated by the combined action of the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH) on the gonads. Although FSH is largely used in female reproduction, in particular in women attending assisted reproductive techniques to stimulate multi-follicular growth, its efficacy in men with idiopathic infertility is not clearly demonstrated. Indeed, whether FSH administration improves fertility in patients with hypogonadotropic hypogonadism, the therapeutic benefit in men presenting alterations in sperm production despite normal FSH serum levels is still unclear. In the present review, we evaluate the potential pharmacological benefits of FSH administration in clinical practice. Methods: This is a narrative review, describing the FSH physiological role in spermatogenesis and its potential therapeutic action in men. Results: The FSH role on male fertility is reviewed starting from the physiological control of spermatogenesis, throughout its mechanism of action in Sertoli cells, the genetic regulation of its action on spermatogenesis, until the therapeutic options available to improve sperm production. Conclusion: FSH administration in infertile men has potential benefits, although its action should be considered by evaluating its synergic action with testosterone, and well-controlled, powerful trials are required. Prospective studies and new compounds could be developed in the near future.

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Pulsatile GnRH Therapy May Restore Hypothalamus–Pituitary–Testis Axis Function in Patients With Congenital Combined Pituitary Hormone Deficiency: A Prospective, Self-Controlled Trial

Cited by 18 publications

References 34 publications

Identification of novel candidate pathogenic genes in pituitary stalk interruption syndrome by whole‐exome sequencing

Identification of novel candidate pathogenic genes in pituitary stalk interruption syndrome by whole‐exome sequencing

Management of Hypopituitarism

Follicle-Stimulating Hormone (FSH) Action on Spermatogenesis: A Focus on Physiological and Therapeutic Roles

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